Organization
PEDIATRIC SERVICES OF AMERICA, INC
Active
Organization
PEDIATRIC SERVICES OF AMERICA, INC
Active
Other names
PSA Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
DALE VALENTINE (VP COMPLIANCE)
(770) 248-8757
Entity
Organization
Contact information
Practice address
1120 W BROAD AVE, UNIT B-1, ALBANY, GA 31707-4397
(229) 435-3387
(229) 435-3847
Mailing address
310 TECHNOLOGY PKWY, NORCROSS, GA 30092-2932
(770) 441-1580
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
047-R-0377
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
538807248C
—
GA
Enumeration date
10/17/2007
Last updated
07/21/2008
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