| NPI | 1407199169 |
|---|---|
| Doing Business As | LAKE ELLA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SAMUEL MENSAH-MAMFO Owner / PIC 850-284-4660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH26779) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2016-12-27 |