Healthcare Provider Details

I. General information

NPI: 1811405202
Provider Name (Legal Business Name): INTEGRIS PROHEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2018
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 SW 44TH ST # F
OKLAHOMA CITY OK
73179-4308
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 405-357-3510
  • Fax: 405-357-3513
Mailing address:
  • Phone: 405-713-7407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number18106
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

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