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General NPI Number Information
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NPI Number | 1588992861
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Entity Type | Organization
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Legal Business Name | INTEGRIS PROHEALTH INC
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 5915 W MEMORIAL RD STE 110
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City | OKLAHOMA CITY
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State | OK
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Zip | 73142-2022
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Country | US
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Telephone | 405-773-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 3435 NW 56TH ST STE 301A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4428
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Country | US
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Telephone | 405-713-7407
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Fax | 405-815-6445
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Authorized Official
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Title or Position | TREASURER
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Name | MICHAEL L WEED
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Credential |
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Telephone | 405-951-2737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1-6900
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License Number State | OK
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