National Provider Identifier Database

PEDIATRIA HEALTHCARE LLC
Medically Fragile Infants and Children Day Care

An entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.).


Contact Information

PEDIATRIA HEALTHCARE, LLC
53 GRAVEL ST
SUITE C
WILKES-BARRE, PA18705-3738
Phone: 770-840-1966
Fax: 770-840-1901
Website:
Specialty Taxonomy Code
* Medically Fragile Infants and Children Day Care 261QM3000X

* Indicates primary specialty

NPI Profile & details for PEDIATRIA HEALTHCARE, LLC

NPI Number 1447492269
Legal business name
LBN
PEDIATRIA HEALTHCARE, LLC
Authorized official MATTHEW BUCKHALTER - (CFO)
Entity Organization
Organization subpart No
Enumeration date 03/25/2009
Last updated 01/27/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • PA Medicaid: 1021992800013

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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