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
4530 PARK RD, STE 105, CHARLOTTE, NC 28209-3716
(704) 335-9797
(704) 335-9970
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
251J00000X
Nursing Care Agency
Primary
HC 0181
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408666
—
NC
05
—
7100144
—
NC
05
—
EX0446
—
SC
Enumeration date
06/29/2006
Last updated
01/27/2025
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