Provider Demographics
NPI:1730568148
Name:PEDIATRIC SERVICES OF AMERICA, INC.
Entity type:Organization
Organization Name:PEDIATRIC SERVICES OF AMERICA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARMON
Authorized Official - Middle Name:A
Authorized Official - Last Name:STRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-441-1580
Mailing Address - Street 1:6 CONCOURSE PKWY
Mailing Address - Street 2:STE 1100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-6117
Mailing Address - Country:US
Mailing Address - Phone:770-441-1580
Mailing Address - Fax:
Practice Address - Street 1:238 LITTLETON RD STE 205
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3531
Practice Address - Country:US
Practice Address - Phone:978-513-6548
Practice Address - Fax:978-250-0818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-19
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care