Organization
LAKE ELLA PHARMACY
Active
Other names
Lake Ella Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL MENSAH-MAMFO (OWNER / PIC)
(850) 284-4660
Entity
Organization
Contact information
Practice address
2525 S MONROE ST STE 6, TALLAHASSEE, FL 32301-6353
(850) 727-8736
(850) 727-8736
Mailing address
4313 MAYLOR LN, TALLAHASSEE, FL 32308-5773
(850) 824-4660
(850) 727-8736
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH26779
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139664
PK
—
Enumeration date
04/01/2013
Last updated
12/27/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us