Healthcare Provider Details

I. General information

NPI: 1255497525
Provider Name (Legal Business Name): INTEGRIS PROHEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 NW 56TH ST STE 140B
OKLAHOMA CITY OK
73112-4430
US

IV. Provider business mailing address

3435 NW 56TH ST STE 301A
OKLAHOMA CITY OK
73112-4428
US

V. Phone/Fax

Practice location:
  • Phone: 405-945-4400
  • Fax: 405-945-4407
Mailing address:
  • Phone: 405-713-7407
  • Fax: 405-815-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1-6901
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL L WEED
Title or Position: TREASURER
Credential:
Phone: 405-951-2737