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Organization
PEDIATRIA HEALTHCARE, LLC
Active
Organization
PEDIATRIA HEALTHCARE, LLC
Active
Other names
Aveanna Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BUCKHALTER (CFO)
(470) 464-8000
Entity
Organization
Contact information
Practice address
1167 N WASHINGTON ST STE E, WILKES BARRE, PA 18705-1856
(570) 371-5606
Mailing address
400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
(470) 464-8000
(770) 248-8192
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
04250501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04250501
HOME HEALTH AGENCY LICENSE
PA
05
—
101299280 0009
—
PA
Enumeration date
12/02/2010
Last updated
01/27/2025
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