NPIMap

Organization Active NPI

Ghaffari Medical Pharmacy

Doing business as colonial heritage personal care

  • Home Health Agency
  • Clovis, NM
National Provider Identifier
1962568386
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
85025038 Issued in NM
Legal business name
GHAFFARI MEDICAL PHARMACY
Doing business as
colonial heritage personal care
Practice address
815 W 14TH St
Clovis, NM 88101-5514
Phone
(505) 762-3294
Fax
(505) 763-0062
NPI assigned
Dec 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Linda R Ghaffari
Title
Owner
Phone
(505) 749-2915

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 85025038 NM Primary

Addresses

Primary practice location

815 W 14TH St
Clovis, NM 88101-5514

Mailing address

121 W 5TH St
Clovis, NM 88101-7301
Phone (505) 762-3294

Other identifiers 1

IdentifierTypeStateIssuer
85025038MedicaidNM

Other names 1

  • colonial heritage personal care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ghaffaris Medical Pharmacy Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962568386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W 5TH ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881017301",
            "telephone_number": "505-762-3294",
            "fax_number": "505-763-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W 14TH ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881015514",
            "telephone_number": "505-762-3294",
            "fax_number": "505-763-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHAFFARI MEDICAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GHAFFARI",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-749-2915",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NM",
            "license": "85025038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85025038",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "colonial heritage personal care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.