Integris Pharmacy 4190
LBN: Integris Prohealth Inc
Integris Pharmacy 4190 is an health care organization with primary practice located at 3433 Nw 56Th St Ste 140B, Oklahoma City OK 73112-4455. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Integris Prohealth Inc can be contacted via phone (405) 945-4400, or through Lane, Joel via phone (405) 949-3120.
Contact Information
Primary practice address
3433 Nw 56Th St Ste 140B
Oklahoma City OK 73112-4455
Phone: (405) 945-4400
Fax: (405) 945-4407
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 1-6901 | Oklahoma |
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1255497525 |
|---|---|
| LBN Legal business name | Integris Prohealth Inc |
| DBA Doing business as | Integris Pharmacy 4190 |
| Authorized official | Lane, Joel RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 29th, 2006 |
| Last updated | Mar 30th, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255497525 | NPPES |
| Oklahoma | MEDICAID | 100239970B | |
| Oklahoma | MEDICAID | 100239970A | |
| Oklahoma | Other | 2074201 |
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