Provider Demographics
NPI:1457797938
Name:PERFECT HEALTH ALWAYS ON CALL, LLC
Entity Type:Organization
Organization Name:PERFECT HEALTH ALWAYS ON CALL, LLC
Other - Org Name:PERFECT HEALTH URGENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:COON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:762-218-3627
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813
Mailing Address - Country:US
Mailing Address - Phone:706-760-7607
Mailing Address - Fax:706-760-7605
Practice Address - Street 1:4244 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809
Practice Address - Country:US
Practice Address - Phone:706-760-7607
Practice Address - Fax:706-760-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-11
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056422261QU0200X, 332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202G706320OtherMEDICARE
GA003164473AMedicaid