1871862870 NPI number — PLUMA CARE PRIVATE DUTY SERVICES, LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871862870 NPI number — PLUMA CARE PRIVATE DUTY SERVICES, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLUMA CARE PRIVATE DUTY SERVICES, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871862870
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 886
Provider Second Line Business Mailing Address:
926 E. CHEROKEE AVE.
Provider Business Mailing Address City Name:
SALLISAW
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74955
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-775-6555
Provider Business Mailing Address Fax Number:
918-775-6587

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
926 E. CHEROKEE AVE.
Provider Second Line Business Practice Location Address:
PETERS AGENCY HOSPICE AND PALLIATIVE CARE, LLC
Provider Business Practice Location Address City Name:
SALLISAW
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-775-6555
Provider Business Practice Location Address Fax Number:
918-775-6587
Provider Enumeration Date:
12/20/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PETERS
Authorized Official First Name:
TRUDY
Authorized Official Middle Name:
ALES
Authorized Official Title or Position:
CEO LHCA
Authorized Official Telephone Number:
918-775-0100

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X , with the licence number: 4284 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)