=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346480902
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PYRA MED HEALTH SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2009
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2125 S 61ST ST
-----------------------------------------------------
City | TEMPLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76504-6823
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-314-8580
-----------------------------------------------------
Fax | 254-774-9980
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 400 INTERSTATE NORTH PKWY SE STE 1600
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30339-5047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-464-8000
-----------------------------------------------------
Fax | 770-248-8192
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | MATTHEW BUCKHALTER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 470-464-8000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 012447
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 13943-LICENSEDHCSSA
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------