NPIMap

Organization Active NPI

Integris Prohealth Inc

Doing business as INTEGRIS Pharmacy 4177

  • Community/Retail Pharmacy
  • Oklahoma City, OK
National Provider Identifier
1356769509
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1-6897 Issued in OK
Legal business name
INTEGRIS PROHEALTH INC
Doing business as
INTEGRIS Pharmacy 4177
Practice address
4401 S Western Ave Ste 1F181
Oklahoma City, OK 73109-3413
Phone
(405) 231-0400
Fax
(405) 815-6445
NPI assigned
Apr 4, 2014
Last updated
Nov 6, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
INTEGRIS PROHEALTH INCAs reported in NPPES

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
Community/Retail Pharmacy 3336C0003X 1-6897 OK Primary

Addresses

Primary practice location

4401 S Western Ave Ste 1F181
Oklahoma City, OK 73109-3413

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
100710550DMedicaidOK
2145444OtherPK

Other names 1

  • INTEGRIS Pharmacy 4177 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140811002288 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 Pharmacy 41774401 S Western Ave, Oklahoma City, OK 73109-3413(405) 231-0400 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 2015

National Provider Directory

National Provider Directory
Part of
Integris Prohealth Inc

Locations

4401 S Western Ave
Ste 1F181
Oklahoma City, OK 73109
Phone (405) 231-0400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1356769509",
    "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": "4401 S WESTERN AVE STE 1F181",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-231-0400",
            "fax_number": "405-815-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRIS PROHEALTH INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRIS PROHEALTH INC",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "1-6897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100710550D",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2145444",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTEGRIS Pharmacy 4177",
            "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.