Lake Oconee Pharmacy & Compounding Center

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009049 Issued in GA

Legal business name

LAKE OCONEE PHARMACY & COMPOUNDING CENTER

Practice address

1124 Greensboro Rd
Suite 104
Eatonton, GA 31024-5549

Phone

(706) 485-4990

Fax

(706) 485-4737

NPI assigned

Oct 23, 2006

Last updated

Aug 22, 2020By 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

Dr. Jonathan Griffin Marquess, PHARMD,CDE,CDM

Title

President

Phone

(706) 485-4990

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689757916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 GREENSBORO RD",
            "address_2": "SUITE 104",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310245549",
            "telephone_number": "706-485-4990",
            "fax_number": "706-485-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 GREENSBORO RD",
            "address_2": "SUITE 104",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310245549",
            "telephone_number": "706-485-4990",
            "fax_number": "706-485-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE OCONEE PHARMACY & COMPOUNDING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARQUESS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "GRIFFIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-485-4990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD,CDE,CDM"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Country Language and Literacy LLC
• Lake Country Pharmacy LLC (Lake Country Compounding & Wellness)
• Lake Country Physical Therapy LLC
• Lake Oconee Medical Associates LLC
• Lake Oconee Partners in Healthcare, LLC
• Lake Oconee Rehabilitation and Performance Center, LLC
• Lake Oconee Urgent and Specialty Care Center
• Lakeside Oral Surgery, LLC
• Haley Brogden Lance, D.C.
• Justin Andrew Lance, D.C.

• Community/Retail Pharmacy in Eatonton, GA
• Providers in Eatonton, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.