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Organization

PEDIATRIC HOME NURSING SERVICES, INC.

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
2250 WEHRLE DR, SUITE 1, WILLIAMSVILLE, NY 14221-7037
(716) 276-2123
(716) 276-2129
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
0577L003
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01853763
NY
05
01855930
NY
Enumeration date
06/28/2006
Last updated
01/27/2025
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