MEDICARE: PERSONAL TOUCH OF WALTERS, OKLAHOMA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	7740	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578529111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL TOUCH OF WALTERS, OKLAHOMA, INC.

Provider Business Mailing Address
First Line	:	PO BOX 245
Second Line	:
City	:	WALTERS
State	:	OK
Zip	:	73572
Country	:	US
Telephone Number	:	580-875-3702
Fax Number	:	580-875-3647

Provider Business Practice Location Address
First Line	:	230 E MISSOURI
Second Line	:
City	:	WALTERS
State	:	OK
Zip	:	73572
Country	:	US
Telephone Number	:	580-875-3702
Fax Number	:	580-875-3647

Authorized Official
Title or Position	:	OFFICE MANAGER/BILLING
Name	:	GLINDA SUE SAGE
Credential	:
Telephone Number	:	580-875-3702

Provider Enumeration Date	:	04/22/2006
Last Update Date	:	03/28/2012

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