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DSH370028A INTEGRIS BAPTIST MEDICAL CENTER, INC. (Terminated)
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Main Details
Name
INTEGRIS BAPTIST MEDICAL CENTER, INC.
Subdivision Name
INTEGRIS SAMARITAN INFUSION
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH370028A
Medicare Provider Number
370028
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/9/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/21/2009
Last Recertification Date
8/10/2015
Termination Date
Termination Reason
1/1/2016
Site closure
Contacts
Authorizing Official
INTEGRIS Health System
Chris Hammes, Executive Vice President
(405) 949-3400
Primary Contact
GEORG LUNDAY, System Administrative Director of Supply Chain and Pharmacy
(405) 949-3039
Addresses
Street Address
3500 NW 56TH, SUITE 201
OKLAHOMA CITY, OK 73112
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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10/6/09 UPDATED ADDR (WAS 3300 NW 56TH STREET)
01/13/2010
April 2025
April 2025
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