Integris Pharmacy 4173

LBN: Integris Prohealth Inc
Integris Pharmacy 4173 is an health care organization with primary practice located at 600 S Monroe St Ste 1A , Enid OK 73701-7211. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Integris Prohealth Inc can be contacted via phone (580) 213-3442, or through Lane, Joel via phone (405) 949-3120.

Contact Information

Primary practice address
600 S Monroe St Ste 1A Enid OK 73701-7211
Phone: (580) 213-3442
Fax: (405) 815-6445
Website:
Map and Directions
Authorized official contact:
Name: Lane, Joel
Phone: (405) 949-3120

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5-7196 Oklahoma

Profile Details

NPI number 1669867396
LBN Legal business name Integris Prohealth Inc
DBA Doing business as Integris Pharmacy 4173
Authorized official Lane, Joel
Entity Organization
Organization subpart 1 No
Enumeration date Mar 31st, 2015
Last updated Mar 17th, 2016 - about 9 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 1669867396 NPPES
Other 2150932 PK
MEDICAID 10070550H PK

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