Provider Demographics
NPI:1396283859
Name:ARILEX MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:ARILEX MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:THEOFILIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO, DABAM, DAAIM
Authorized Official - Phone:412-477-4493
Mailing Address - Street 1:6125 BROADWATER TRL
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-9521
Mailing Address - Country:US
Mailing Address - Phone:412-477-4493
Mailing Address - Fax:470-281-5129
Practice Address - Street 1:5983 HIGHWAY 53 E STE 100
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-9512
Practice Address - Country:US
Practice Address - Phone:412-477-4493
Practice Address - Fax:470-281-5129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction MedicineGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone