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DSH370106 INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION (Active)
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Main Details
Name
INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH370106
Medicare Provider Number
370106
Additional Details
Current Program Status
Active
Registration Date
6/2/2009
Participating Start Date
7/1/2009
Participating Approval Date
6/8/2009
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
INTEGRIS Health
Georg F. Lunday, Chief Pharmacy Officer
(405) 401-4842
Primary Contact
INTEGRIS Health
Christopher K. Yang, 340B Coordinator
(405) 795-2545
Addresses
Street Address
4401 SOUTH WESTERN AVE
OKLAHOMA CITY, OK 73109
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/13/12 UPDATED MAIN ADD (WAS 4401 S WESTERN AVENUE, OKLAHOMA CITY, OK 73109); 5/22/09-DOC RECD TO CONFIRM ELIG DSH ADJ %
02/13/2012
5/22/09-DOC RECD TO CONFIRM ELIG DSH ADJ %
08/22/2010
May 2025
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