Provider Demographics
NPI:1902095417
Name:PERIMETER SURGICAL CENTER INC
Entity Type:Organization
Organization Name:PERIMETER SURGICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-766-5438
Mailing Address - Street 1:6620 PERIMETER DR
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8055
Mailing Address - Country:US
Mailing Address - Phone:614-766-5438
Mailing Address - Fax:614-408-8269
Practice Address - Street 1:6620 PERIMETER DR
Practice Address - Street 2:SUITE 100B
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8055
Practice Address - Country:US
Practice Address - Phone:614-766-5438
Practice Address - Fax:614-408-8269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-21
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical