# ANGUS LAKE HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gordon Compounding Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275637787
- **Authorized official:** CARLA SAPPE PHARMD (PHARMACIST IN CHARGE)
- **Authorized official phone:** (478) 628-2425

## Contact information

- **Practice address:** 240 MILLEDGEVILLE HWY \# A, GORDON, GA 31031-3827
- **Practice address phone:** (478) 628-2425
- **Practice address fax:** (478) 628-2263
- **Mailing address:** PO BOX 249, 240A MILLEDGEVILLE ROAD, GORDON, GA 31031-0249
- **Mailing address phone:** (478) 628-2425
- **Mailing address fax:** (478) 628-2263

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHRE008912 | GA | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 08/22/2020