340B Drug Pricing Program Database
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DSH370113 INTEGRIS GROVE HOSPITAL (Active)
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Main Details
Name
INTEGRIS GROVE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH370113
Medicare Provider Number
370113
Additional Details
Current Program Status
Active
Registration Date
10/11/2021
Participating Start Date
1/1/2022
Participating Approval Date
12/7/2021
Last Recertification Date
8/22/2024
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
1001 EAST 18TH STREET
GROVE, OK 74344
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/16/10 PHYS ADDR CHANGE (WAS 1310 SOUTH MAIN STREET)
06/16/2010
April 2025
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