Provider Demographics
NPI:1306865357
Name:INTEGRIS RURAL HEALTH INC
Entity Type:Organization
Organization Name:INTEGRIS RURAL HEALTH INC
Other - Org Name:INTEGRIS CANADIAN VALLEY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-949-3402
Mailing Address - Street 1:5400 N INDEPENDENCE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5300
Mailing Address - Country:US
Mailing Address - Phone:405-713-5506
Mailing Address - Fax:
Practice Address - Street 1:1201 HEALTH CENTER PKWY
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6381
Practice Address - Country:US
Practice Address - Phone:405-717-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2343282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100700610AMedicaid
OK900522062Medicare PIN
OK370211Medicare Oscar/Certification