Provider Demographics
NPI:1043725443
Name:MELFAH, SAMUEL OFOSU (PHARMD,PHC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:OFOSU
Last Name:MELFAH
Suffix:
Gender:M
Credentials:PHARMD,PHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 BLAZON GOLD WAY
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-0674
Mailing Address - Country:US
Mailing Address - Phone:915-408-3475
Mailing Address - Fax:
Practice Address - Street 1:14476 HORIZON BLVD STE J
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-8579
Practice Address - Country:US
Practice Address - Phone:915-852-8884
Practice Address - Fax:915-975-5893
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX450171835P0018X, 1835P0200X, 1835P1200X, 1835P1300X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P0200XPharmacy Service ProvidersPharmacistPediatrics
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric