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NPI Code Detail

MEDICARE: INTEGRIS BASS BAPTIST HEALTH CENTER

MEDICARE: INTEGRIS BASS BAPTIST HEALTH CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR1300XRural Health Clinic/Center

General Provider Information

NPI Number : 1205436938
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRIS BASS BAPTIST HEALTH CENTER
Provider Business Mailing Address
First Line : 5400 N INDEPENDENCE AVE STE 200
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-5300
Country : US
Telephone Number : 405-713-5515
Fax Number : 405-713-5532
Provider Business Practice Location Address
First Line : 1805 W OWEN K GARRIOTT RD
Second Line :
City : ENID
State : OK
Zip : 73703-5526
Country : US
Telephone Number : 580-233-9012
Fax Number :
Authorized Official
Title or Position : SENIOR VICE PRESIDENT & COO
Name : CHRIS HAMMES
Credential :
Telephone Number : 405-949-3402
Provider Enumeration Date : 10/30/2020
Last Update Date : 04/12/2021

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Directions to “INTEGRIS BASS BAPTIST HEALTH CENTER ” Practice Location

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