340B Drug Pricing Program Database
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DSH370028C INTEGRIS BAPTIST MEDICAL CENTER (Active)
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Main Details
Name
INTEGRIS BAPTIST MEDICAL CENTER
Subdivision Name
INTEGRIS COMPREHENSIVE BREAST CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH370028C
Medicare Provider Number
370028
Outpatient Facility Provider Number
370028
Additional Details
Current Program Status
Active
Registration Date
12/19/2019
Participating Start Date
1/1/2020
Participating Approval Date
12/26/2019
Last Recertification Date
8/29/2024
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
3525 NW 56TH STREET
SUITE C100
Oklahoma City, OK 73112
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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