Organization
IACC/EHI NW, LLC
Active
Other names
INTEGRIS Community Hospital - Moore
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BUCK MD (SECRETARY)
(713) 637-1004
Entity
Organization
Contact information
Practice address
1401 SW 34TH ST, MOORE, OK 73160-3059
(405) 500-3330
(405) 793-1315
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
—
200834400D
—
OK
01
—
2388
HOSPITAL LICENSE
OK
01
—
370240
MEDICARE
OK
Enumeration date
09/18/2018
Last updated
09/10/2019
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