Provider Demographics
NPI:1871644823
Name:PERLOW FACILITY, LLC
Entity Type:Organization
Organization Name:PERLOW FACILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:PERLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-951-0866
Mailing Address - Street 1:2520 WINDY HILL RD SE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8664
Mailing Address - Country:US
Mailing Address - Phone:770-951-0866
Mailing Address - Fax:
Practice Address - Street 1:2520 WINDY HILL RD SE
Practice Address - Street 2:SUITE 305
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8664
Practice Address - Country:US
Practice Address - Phone:770-951-0866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025014261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical