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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 Specialty Code Provider Type

Medically Fragile Infants and Children Day Care

261QM3000X
Indicates primary specialty

NPI Profile & details for PEDIATRIA HEALTHCARE, LLC

NPI Number 1447492269
LBN Legal business name PEDIATRIA HEALTHCARE, LLC
Authorized official MATTHEW BUCKHALTER - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 03/25/2009
Last updated 01/27/2025 - More than a year ago
Identifiers
PA Medicaid 1021992800013
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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