Organization
INTEGRIS BAPTIST MEDICAL CENTER INC
Active
Parent organization
INTEGRIS BAPTIST MEDICAL CENTER INC
Other names
INTEGRIS Health Portland Ave Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTEGRIS BAPTIST MEDICAL CENTER INC
Authorized official
DONNA M WALLACE (ASSISTANT TREASURER)
(636) 359-4890
Entity
Organization
Contact information
Practice address
5501 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2074
(405) 604-6000
Mailing address
PO BOX 200757, DALLAS, TX 75320-0757
(405) 252-8319
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336I0012X
Institutional Pharmacy
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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