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DSH370028G INTEGRIS BAPTIST MEDICAL CENTER (Active)
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Main Details
Name
INTEGRIS BAPTIST MEDICAL CENTER
Subdivision Name
INTEGRIS BAPTIST MEDICAL CENTER - SLEEP MEDICINE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH370028G
Medicare Provider Number
370028
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/11/2019
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
3300 NW 56TH STREET
SUITE 301
Oklahoma City, OK 73112
Billing Address
INTEGRIS Baptist Medical Center - OP Sleep Lab
PO Box 268907
Oklahoma City, OK 73126-8907
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating start date 7/1/15; Termination date 1/1/2017; Reinstated 1/1/20.
10/22/2019
April 2025
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