Healthcare Provider Details

I. General information

NPI: 1659971398
Provider Name (Legal Business Name): INTEGRIS BASS BAPTIST HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2020
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N CHEROKEE ST
HENNESSEY OK
73742-1106
US

IV. Provider business mailing address

5400 N INDEPENDENCE AVE STE 200
OKLAHOMA CITY OK
73112-5300
US

V. Phone/Fax

Practice location:
  • Phone: 405-853-7171
  • Fax:
Mailing address:
  • Phone: 405-713-5515
  • Fax: 405-713-5532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRIS HAMMES
Title or Position: SENIOR VICE PRESIDENT & COO
Credential:
Phone: 405-949-3402