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DSH370106A INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION (Active)
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Main Details
Name
INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION
Subdivision Name
INTEGRIS SOUTHWEST MEDICAL CENTER - CANCER CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH370106A
Medicare Provider Number
370106
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/21/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/17/2012
Last Recertification Date
9/3/2024
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
4301 S 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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June 2025
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