Provider Demographics
NPI:1811303928
Name:PERIMETER HEALTHCARE GROUP LLC
Entity type:Organization
Organization Name:PERIMETER HEALTHCARE GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MGR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-730-6240
Mailing Address - Street 1:1140 HAMMOND DR
Mailing Address - Street 2:SUITE 110, BLDG K
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5338
Mailing Address - Country:US
Mailing Address - Phone:770-454-8300
Mailing Address - Fax:678-730-0280
Practice Address - Street 1:2133 HIGHWAY 317
Practice Address - Street 2:STE 12-318
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2649
Practice Address - Country:US
Practice Address - Phone:678-730-6240
Practice Address - Fax:678-730-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty