MEDICARE: INTEGRIS PROHEALTH 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	3336S0011X	Specialty Pharmacy
2	3336C0003X	Community/Retail Pharmacy	1-6900	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2121523	OTHER	PK

General Provider Information

NPI Number	:	1588992861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRIS PROHEALTH INC

Provider Business Mailing Address
First Line	:	3435 NW 56TH ST STE 301A
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4428
Country	:	US
Telephone Number	:	405-713-7407
Fax Number	:	405-815-6445

Provider Business Practice Location Address
First Line	:	5915 W MEMORIAL RD STE 110
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73142-2022
Country	:	US
Telephone Number	:	405-773-2300
Fax Number	:

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

Provider Enumeration Date	:	11/25/2009
Last Update Date	:	11/06/2025

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Directions to “INTEGRIS PROHEALTH INC ” Practice Location

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