Active NPI
Integris Prohealth Inc
- Community/Retail Pharmacy
- Oklahoma City, OK
National Provider Identifier
1679614531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 16898
- Legal business name
- INTEGRIS PROHEALTH INC
- Practice address
- 4221 S Western Ave Ste 1020
Oklahoma City, OK 73109-3448 - Phone
- (405) 636-7717
- Fax
- (405) 636-7542
- NPI assigned
- Feb 12, 2007
- Organization subpart
- Yes
- Parent organization
- INTEGRIS PROHEALTH INC
NPPES NPI Registry
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 16898 | OK | Primary |
Addresses
Primary practice location
4221 S Western Ave Ste 1020
Oklahoma City, OK 73109-3448
Mailing address
3435 NW 56TH St Ste 301a
Oklahoma City, OK 73112-4428
Phone (405) 713-7407
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2141245 | Other | PK | |
| 100243020A | Medicaid | OK | |
| 100243020B | Medicaid | OK |
Other names 1
- INTEGRIS Pharmacy 4185
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130920000398 | 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 NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Integris Pharmacy 4185 | Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
National Provider Directory
National Provider Directory- Part of
- Prohealth Phys
Locations
3435 NW 56th St
Ste 301
Oklahoma City, OK 73112
4221 S Western Ave
Ste 1020
Oklahoma City, OK 73109
Phone (405) 636-7717
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762387200000",
"number": "1679614531",
"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": "4221 S WESTERN AVE STE 1020",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731093448",
"telephone_number": "405-636-7717",
"fax_number": "405-636-7542"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTEGRIS PROHEALTH INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "INTEGRIS PROHEALTH INC",
"enumeration_date": "2007-02-12",
"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": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "OK",
"license": "16898",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2141245",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100243020A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100243020B",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "INTEGRIS Pharmacy 4185",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Oklahoma City, OK
- Integris Prohealth Inc
- Integris Prohealth Inc
- Integris Prohealth Inc
- Integris Prohealth Inc
- Integris Prohealth Inc
- Integris Prohealth Inc
- Integris Prohealth Inc
- Integris South Oklahoma City Corporation
- Integris South Oklahoma City Hospital Corp Dba Ismc Hospitalists
- Integris South Oklahoma City Hospital Corporation
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.