340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
INTEGRIS BAPTIST MEDICAL CENTER, INC
DSH370113 INTEGRIS GROVE HOSPITAL
Print
Covered Entity Details
Entity Name
INTEGRIS GROVE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH370113
Entity Address
1001 EAST 18TH STREET
GROVE, OK 74344
Medicare Provider Number
370113
Participating Start Date
1/1/2022
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
INTEGRIS BAPTIST MEDICAL CENTER, INC
Pharmacy Address
DBA INTEGRIS CANCER INSTITUTE OF OKLA PR
5911 W MEMORIAL RD
OKLAHOMA CITY, OK 73142
Pharmacy Comments
Contract Details
Approval Date
10/17/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tim Bowen, President
(918) 787-3400
Contract Pharmacy Representative
INTEGRIS Health
Georg F. Lunday, Chief Pharmacy Officer
(405) 401-4842
Signed By Date
10/17/2016
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session