Provider Demographics
NPI:1023415197
Name:PERIGON INC
Entity type:Organization
Organization Name:PERIGON INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:KRISTINE
Authorized Official - Last Name:PERIGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-275-6315
Mailing Address - Street 1:4123 WESTWARD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-1043
Mailing Address - Country:US
Mailing Address - Phone:614-275-6315
Mailing Address - Fax:
Practice Address - Street 1:4123 WESTWARD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1043
Practice Address - Country:US
Practice Address - Phone:614-275-6315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHIC00746171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty