Ergogenic Labs LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PH27127 Issued in FL

Legal business name

ERGOGENIC LABS LLC

Doing business as

Ergogenic Labs LLC

Practice address

11496 Pierson Rd Ste C6
Wellington, FL 33414-8708

Phone

(561) 408-2361

Fax

(561) 408-2365

NPI assigned

Oct 21, 2013

Last updated

Dec 19, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott Mangini

Title

Pharmacy Manager

Phone

(561) 408-2361

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Ergogenic Labs LLC Doing business as

Locations

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

{
    "created_epoch": "1382313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387411200000",
    "number": "1093143570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11496 PIERSON RD STE C6",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148708",
            "telephone_number": "561-408-2361",
            "fax_number": "561-408-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11496 PIERSON RD STE C6",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148708",
            "telephone_number": "561-408-2361",
            "fax_number": "561-408-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERGOGENIC LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-21",
        "last_updated": "2013-12-19",
        "status": "A",
        "authorized_official_last_name": "MANGINI",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "561-408-2361"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "FL",
            "license": "PH27127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142715",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ergogenic Labs LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Empower Me Clinical Practice, LLC (Dr. Selena LaMotte, DSW)
• Empowernet Inc
• Carol P Ennis, APRN
• Robert S Epstein, MD
• Norman H Erenrich, MD
• Scott Erickson, ARNP
• Julia Escandon Brehm, MD, PHD
• Roosevelt Espenilla
• Karla Espinosa, RBT
• Livertha Estefont, RN, BSN

• Compounding Pharmacy in Wellington, FL
• Providers in Wellington, FL by specialty
• Compounding Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.