Provider Demographics
NPI:1235800277
Name:PERIMETER SPECIALTY PHARMACY, LLC
Entity Type:Organization
Organization Name:PERIMETER SPECIALTY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDNI
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAKTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:361-522-2201
Mailing Address - Street 1:5671 PEACHTREE DUNWOODY RD STE 225
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-5067
Mailing Address - Country:US
Mailing Address - Phone:470-750-0700
Mailing Address - Fax:
Practice Address - Street 1:5671 PEACHTREE DUNWOODY RD STE 225
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-5067
Practice Address - Country:US
Practice Address - Phone:470-750-0700
Practice Address - Fax:470-276-7131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-21
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy