Lake Ella Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH26779 Issued in FL

Legal business name

LAKE ELLA PHARMACY

Doing business as

Lake Ella Pharmacy

Practice address

2525 S Monroe St Ste 6
Tallahassee, FL 32301-6353

Phone

(850) 727-8736

Fax

(850) 727-8736

NPI assigned

Apr 1, 2013

Last updated

Dec 27, 2016By 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

Samuel Mensah-Mamfo

Title

Owner / Pic

Phone

(850) 284-4660

Specialties & licenses 2

Addresses

Other names 1

• Lake Ella Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1407199169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 MAYLOR LN",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085773",
            "telephone_number": "850-824-4660",
            "fax_number": "850-727-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MONROE ST STE 6",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323016353",
            "telephone_number": "850-727-8736",
            "fax_number": "850-727-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ELLA PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-01",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "MENSAH-MAMFO",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER / PIC",
        "authorized_official_telephone_number": "850-284-4660"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH26779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Ella Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angele Margarita Lagrave, LMT
• Evan Lahtinen, CRNA
• Christopher Austin Laing, D.D.S
• Rhonda Rose Laing, RPH
• Katherine Elizabeth Lajeunesse, SLP
• Lake Oliver Emergency Group, LLC
• Lake Oliver Emergency Group, LLC
• Lake Oliver Emergency Group, LLC
• Gurusami M. Lakshmin, M.D.
• Saanvi Lalwani

• Community/Retail Pharmacy in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.