Healthcare Provider Details

I. General information

NPI: 1447022090
Provider Name (Legal Business Name): INTEGRIS HEALTH WOODWARD HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 SW 7TH ST
MOORELAND OK
73852-7602
US

IV. Provider business mailing address

3001 QUAIL SPRINGS PKWY FL 3
OKLAHOMA CITY OK
73134-2640
US

V. Phone/Fax

Practice location:
  • Phone: 580-994-2180
  • Fax:
Mailing address:
  • Phone: 405-252-8400
  • Fax:

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: DONNA WALLACE
Title or Position: ASSISTANT TREASURER
Credential:
Phone: 636-359-4890