Provider Demographics
NPI:1588243117
Name:INTEGRIS HEALTH EDMOND, INC
Entity type:Organization
Organization Name:INTEGRIS HEALTH EDMOND, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-949-3402
Mailing Address - Street 1:PO BOX 960423
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0423
Mailing Address - Country:US
Mailing Address - Phone:405-657-3030
Mailing Address - Fax:405-471-0003
Practice Address - Street 1:4801 INTEGRIS PKWY
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-8864
Practice Address - Country:US
Practice Address - Phone:405-657-3030
Practice Address - Fax:405-471-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit