# LAKE OCONEE PHARMACY & COMPOUNDING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689757916
- **Authorized official:** DR. JONATHAN GRIFFIN MARQUESS PHARMD,CDE,CDM (PRESIDENT)
- **Authorized official phone:** (706) 485-4990

## Contact information

- **Practice address:** 1124 GREENSBORO RD, SUITE 104, EATONTON, GA 31024-5549
- **Practice address phone:** (706) 485-4990
- **Practice address fax:** (706) 485-4737
- **Mailing address:** 1124 GREENSBORO RD, SUITE 104, EATONTON, GA 31024-5549
- **Mailing address phone:** (706) 485-4990
- **Mailing address fax:** (706) 485-4737

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHRE009049 | GA | Yes |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 08/22/2020