MEDICARE: PETERS AGENCY HOME CARE, LLC

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	251C00000X	Developmentally Disabled Services Day Training Agency	7891	OK
2	376J00000X	Homemaker	7891	OK
3	3747P1801X	Personal Care Attendant	7891	OK
4	253Z00000X	In Home Supportive Care Agency	7891	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	:	1245568070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETERS AGENCY HOME CARE, LLC

Provider Business Mailing Address
First Line	:	1015 EAST CHOCTAW AVENUE
Second Line	:
City	:	SALLISAW
State	:	OK
Zip	:	74955-5011
Country	:	US
Telephone Number	:	918-790-7555
Fax Number	:	918-790-7587

Provider Business Practice Location Address
First Line	:	1015 EAST CHOCTAW AVENUE
Second Line	:
City	:	SALLISAW
State	:	OK
Zip	:	74955-5011
Country	:	US
Telephone Number	:	918-790-7555
Fax Number	:	918-790-7587

Authorized Official
Title or Position	:	CEO
Name	:	MRS. TRUDY A PETERS
Credential	:	MBA, RN, CCM, LHCA
Telephone Number	:	918-775-6555

Provider Enumeration Date	:	12/07/2009
Last Update Date	:	06/10/2010

Similar Medicare Providers

1649217191 — DR. JOHN P AGENT DO
Practice Location Address:

1015 E CHOCTAW AVE
SALLISAW, OK
74955-5011

Practice Phone: 918-774-0034
Practice Fax: 918-774-0650

1851633671 — PETERS AGENCY HYPERBARICS LLC
Practice Location Address:

1015 E CHOCTAW AVE
SALLISAW, OK
74955-5011

Practice Phone: 918-775-6555
Practice Fax:

1497280630 — CHELSEA AGENT REAL DNP, APRN, FNP-C
Practice Location Address:

1015 E CHOCTAW AVE
SALLISAW, OK
74955-5011

Practice Phone: 918-774-0034
Practice Fax:

1902555667 — WESTON PATRICK CHOATE DO
Practice Location Address:

301 S J T STITES ST
SALLISAW, OK
74955-9302

Practice Phone: 918-774-1400
Practice Fax: 918-774-0915

1881690105 — JEFFREY S SANDERS DPH
Practice Location Address:

301 J T STITES BLVD
SALLISAW, OK
74955-9302

Practice Phone: 918-775-9159
Practice Fax: 918-775-4778

1578563060 — CLIFS PHARMACY LLC
Practice Location Address:

505 E REDWOOD AVE
SALLISAW, OK
74955-3020

Practice Phone: 918-776-0100
Practice Fax: 918-775-4749

Directions to “PETERS AGENCY HOME CARE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.