Integris Pharmacy 4175

LBN: Integris Prohealth Inc
Integris Pharmacy 4175 is an health care organization with primary practice located at 601 E 13Th St Ste B , Grove OK 74344-2962. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Integris Prohealth Inc can be contacted via phone (405) 949-3120, or through Ahlden, Casey Leigh via phone (405) 252-8501.

Contact Information

Primary practice address
601 E 13Th St Ste B Grove OK 74344-2962
Phone: (405) 949-3120
Fax: (405) 815-6445
Website:
Map and Directions
Authorized official contact:
Name: Ahlden, Casey Leigh
Phone: (405) 252-8501

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1629769393
LBN Legal business name Integris Prohealth Inc
DBA Doing business as Integris Pharmacy 4175
Authorized official Ahlden, Casey Leigh
Entity Organization
Organization subpart 1 No
Enumeration date May 15th, 2023
Last updated Apr 4th, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629769393 NPPES
Oklahoma MEDICAID 100791460B

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