Organization
PEDIATRIC SERVICES OF AMERICA, 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
1400 N PROVIDENCE RD STE 300 SOUTH, MEDIA, PA 19063-2050
(215) 887-4009
(215) 887-4246
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
758305
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100007962 0017
—
PA
Enumeration date
06/26/2006
Last updated
01/27/2025
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