INTEGRIS AMBULATORY CARE CORPORATION NPI 1023039187

NPI Information

NPI: 1023039187
Provider Name: INTEGRIS AMBULATORY CARE CORPORATION

Doing Business As: INTEGRIS JIM THORPE OP REHAB

Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
2111 RIVERWALK DR
MOORE, OK
ZIP 73160
Phone: (405) 793-7885
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INTEGRIS AMBULATORY CARE CORPORATION is a rehabilitation clinic center in Moore, OK. INTEGRIS AMBULATORY CARE CORPORATION NPI is 1023039187. The provider is registered as an organization entity type.
The provider Is Doing Business As Integris Jim Thorpe Op Rehab.

The provider's business location address is:

2111 RIVERWALK DR
MOORE, OK
ZIP 73160-700
Phone: (405) 793-7885

The provider's authorized official is C Bruce Lawrence .
The authorized official title is President/ceo and has the following contact phone number (405) 949-6066.

The CLIA number assigned to this NPI record is 37D0663764 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/22/2006 and was last updated on 4/8/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	376538	MEDICARE OSCAR/CERTIFICATION	OKLAHOMA
2	100736700A	MEDICAID	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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