# COMPOUNDING SPECIALISTS AT LAKE OCONEE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Country Pharmacy & Compounding Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336323567
- **Authorized official:** CAREY VAUGHAN PHARMD (CEO)
- **Authorized official phone:** (706) 923-2933

## Contact information

- **Practice address:** 1110 COMMERCE DR STE 110, GREENSBORO, GA 30642-7444
- **Practice address phone:** (706) 923-2933
- **Practice address fax:** (706) 923-2930
- **Mailing address:** 1110 COMMERCE DR STE 110, GREENSBORO, GA 30642-7444
- **Mailing address phone:** (706) 923-2933
- **Mailing address fax:** (706) 923-2930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE009902 | GA | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 12/24/2007
- **Last updated:** 02/20/2017