Provider Demographics
NPI:1831493790
Name:PEDIATRIC SERVICES OF AMERICA, INC
Entity Type:Organization
Organization Name:PEDIATRIC SERVICES OF AMERICA, INC
Other - Org Name:PSA HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCCURRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-441-1580
Mailing Address - Street 1:6 CONCOURSE PKWY NE
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:770-248-8192
Practice Address - Street 1:6316 SAINT ANDREWS RD
Practice Address - Street 2:STE A
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-3168
Practice Address - Country:US
Practice Address - Phone:803-454-9730
Practice Address - Fax:803-454-9735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2015-06-04
Deactivation Date:2014-04-02
Deactivation Code:
Reactivation Date:2015-06-04
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care