Provider Demographics
NPI:1376255117
Name:INTEGRIS HEALTH EDMOND, INC
Entity Type:Organization
Organization Name:INTEGRIS HEALTH EDMOND, INC
Other - Org Name:INTEGRIS HEALTH EDMOND HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:AHLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-252-8501
Mailing Address - Street 1:PO BOX 200180
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-0180
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4801 INTEGRIS PKWY
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-8864
Practice Address - Country:US
Practice Address - Phone:405-657-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-22
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital