NPIMap

Organization Active NPI

Integris Baptist Medical Center Inc

Doing business as INTEGRIS Health Portland Ave Pharmacy

  • Pharmacy
  • Oklahoma City, OK
National Provider Identifier
1619721784
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
INTEGRIS BAPTIST MEDICAL CENTER INC
Doing business as
INTEGRIS Health Portland Ave Pharmacy
Practice address
5501 N Portland Ave
Oklahoma City, OK 73112-2074
Phone
(405) 604-6000
NPI assigned
Apr 15, 2024
Last updated
Apr 15, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
INTEGRIS BAPTIST MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Authorized official

Name
Donna M Wallace
Title
Assistant Treasurer
Phone
(636) 359-4890

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary
Institutional Pharmacy 3336I0012X NU

Addresses

Primary practice location

5501 N Portland Ave
Oklahoma City, OK 73112-2074

Mailing address

PO Box 200757
Dallas, TX 75320-0757
Phone (405) 252-8319

Other names 1

  • INTEGRIS Health Portland Ave Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Integris Baptist Med Ce13 organizations share this tax ID, including this one
Part of
Integris Baptist Med Ce

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1619721784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200757",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753200757",
            "telephone_number": "405-252-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122074",
            "telephone_number": "405-604-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRIS BAPTIST MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRIS BAPTIST MEDICAL CENTER INC",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ASSISTANT TREASURER",
        "authorized_official_telephone_number": "636-359-4890"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTEGRIS Health Portland Ave Pharmacy",
            "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 Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.