NPIMap

Organization Active NPI

Integris Prohealth Inc

Doing business as INTEGRIS Pharmacy 4176

  • Community/Retail Pharmacy
  • Oklahoma City, OK
National Provider Identifier
1093133241
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1-6896 Issued in OK
Legal business name
INTEGRIS PROHEALTH INC
Doing business as
INTEGRIS Pharmacy 4176
Practice address
3300 NW Expressway Ste 1D1191
Oklahoma City, OK 73112-4418
Phone
(405) 951-2345
Fax
(405) 951-2365
NPI assigned
Apr 4, 2014
Last updated
Nov 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael L Weed
Title
Treasurer
Phone
(405) 951-2737

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 1-6896 OK Primary

Addresses

Primary practice location

3300 NW Expressway Ste 1D1191
Oklahoma City, OK 73112-4418

Mailing address

3435 NW 56TH St Ste 301a
Oklahoma City, OK 73112-4428
Phone (405) 713-7407

Other identifiers 3

IdentifierTypeStateIssuer
2145259OtherPK
100710550CMedicaidOK
100710550FMedicaidOK

Other names 1

  • INTEGRIS Pharmacy 4176 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140811001986 OK DME Supplier - Pharmacy 5092792127 Practice locations: Oklahoma City, OK
O20150903002048 OK Part B Supplier - Mass Immunization (Roster Biller Only) 5092792127 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edmond, OK; Enid, OK; Grove, OK; Oklahoma City, OK; Yukon, OK

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Integris Prohealth Pharmacy-NW Expr3300 NW Expressway, Oklahoma City, OK 73112-4418(405) 951-2345 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 2015

National Provider Directory

National Provider Directory

Locations

3300 N West Expy
Ste 1D1191
Oklahoma City, OK 73112
Phone (405) 951-2345

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1093133241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 NW 56TH ST STE 301A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124428",
            "telephone_number": "405-713-7407",
            "fax_number": "405-815-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY STE 1D1191",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124418",
            "telephone_number": "405-951-2345",
            "fax_number": "405-951-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRIS PROHEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-04",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "WEED",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "405-951-2737"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "1-6896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2145259",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100710550C",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100710550F",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTEGRIS Pharmacy 4176",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "INTEGRIS Pharmacy 4176",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.