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Organization
IACC/EHI NW, LLC
Active
Organization
IACC/EHI NW, LLC
Active
Other names
Integris Community Hospital-Council Crossing
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BUCK MD (SECRETARY)
(713) 637-1004
Entity
Organization
Contact information
Practice address
9417 N COUNCIL RD, OKLAHOMA CITY, OK 73162-6207
(877) 516-0911
(281) 292-3585
Mailing address
8686 NEW TRAILS DR STE 100, THE WOODLANDS, TX 77381-1176
(713) 637-1146
(281) 465-8414
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200834400A
—
OK
01
—
2388
HOSPITAL LICENSE
OK
01
—
370240
MEDICARE
OK
Enumeration date
09/17/2018
Last updated
09/10/2019
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