340B Drug Pricing Program Database
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DSH370028B INTEGRIS BAPTIST MEDICAL CENTER (Active)
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Main Details
Name
INTEGRIS BAPTIST MEDICAL CENTER
Subdivision Name
INTEGRIS CANCER INSTITUTE OF OKLAHOMA (ICIO)
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH370028B
Medicare Provider Number
370028
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/10/2019
Participating Start Date
1/1/2020
Participating Approval Date
11/15/2019
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
5911 WEST MEMORIAL ROAD
OKLAHOMA CITY, OK 73142
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating start date 1/1/2010; Terminated 1/1/2017; Reinstated 1/1/2020.
10/22/2019
2/13/12 UPDATED MAIN ADD (WAS 5911 W. MEMORIAL ROAD, OKLAHOMA CITY, OK 73142)
02/13/2012
April 2025
April 2025
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