340B Drug Pricing Program Database

Pharmacy Name

INTEGRIS PHARMACY 4190

Pharmacy Address

3433 NW 56TH ST., STE 140B
OKLAHOMA CITY, OK 73112

Pharmacy Comments

2/13/12 UPDATED ADD (WAS 3443 NW 56TH ST)

Approval Date

11/25/2011

Contract Begin Date

11/25/2011

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2019
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Chris Hammas, President & Managing Director of IBMC
(405) 949-3400

Contract Pharmacy Representative

Bruce C. Lawrence, President & CEO
(405) 949-3177

Signed By Date

11/11/2011