MEDICARE: INTEGRIS RURAL HEALTH 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	207R00000X	Internal Medicine Physician
2	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487800512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRIS RURAL HEALTH INC

Provider Business Mailing Address
First Line	:	PO BOX 960353
Second Line	:
City	:	OKLAHOMA
State	:	OK
Zip	:	73196-0353
Country	:	US
Telephone Number	:	580-548-1367
Fax Number	:	580-548-1583

Provider Business Practice Location Address
First Line	:	402 S OAKWOOD RD STE B
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73703-4945
Country	:	US
Telephone Number	:	580-234-1831
Fax Number	:	580-234-1834

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	GREG A MEYERS
Credential	:
Telephone Number	:	580-548-1367

Provider Enumeration Date	:	08/08/2008
Last Update Date	:	07/10/2013

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