MEDICARE: INTEGRIS BAPTIST MEDICAL CENTER INC

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
1	332BX2000X	Oxygen Equipment & Supplies (DME)
2	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1366722183
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRIS BAPTIST MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	4120 N PORTLAND AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6311
Country	:	US
Telephone Number	:	405-945-4411
Fax Number	:

Provider Business Practice Location Address
First Line	:	4120 N PORTLAND AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6311
Country	:	US
Telephone Number	:	405-945-4411
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	MICHAEL L WEED
Credential	:
Telephone Number	:	405-951-2737

Provider Enumeration Date	:	08/24/2011
Last Update Date	:	12/18/2025

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