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General NPI Number Information
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NPI Number | 1306865357
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Entity Type | Organization
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Legal Business Name | INTEGRIS CANADIAN VALLEY HOSPITAL
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1201 HEALTH CENTER PKWY
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City | YUKON
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State | OK
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Zip | 73099-6381
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Country | US
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Telephone | 405-717-6800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 200173
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City | DALLAS
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State | TX
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Zip | 75320-0173
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Country | US
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Telephone | 405-252-8400
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Fax |
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Authorized Official
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Title or Position | ASSISTANT TREASURER
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Name | DONNA WALLACE
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Credential |
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Telephone | 636-359-4890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 2343
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License Number State | OK
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