Lake Ella Pharmacy
Organization Active NPI Community/Retail Pharmacy · Tallahassee, FL
NPI 1407199169 · NPPES record last updated Dec 27, 2016
Key facts
- NPI
- 1407199169
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PH26779 (FL)
- Legal business name
- 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
- Organization subpart
- No
Authorized official
- Name
- Samuel Mensah-Mamfo
- Title
- Owner / Pic
- Phone
- (850) 284-4660
National Provider Directory
Locations
2525 S Monroe St
Ste 6
Tallahassee, FL 32301
Phone (850) 727-8736
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PH26779 | FL | Yes |
Addresses
Primary practice location
2525 S Monroe St Ste 6
Tallahassee, FL 32301-6353
Mailing address
4313 Maylor LN
Tallahassee, FL 32308-5773
Phone (850) 824-4660
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2139664 | Other | PK |
Other names
- Lake Ella Pharmacy
Other providers in Tallahassee, FL
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- Rhonda Rose Laing
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- Gurusami M. Lakshmin
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All providers in Tallahassee, FL · Community/Retail Pharmacy in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.