Provider Demographics
NPI:1356580997
Name:INTEGRIS SOUTHWEST MEDICAL CENTER
Entity type:Organization
Organization Name:INTEGRIS SOUTHWEST MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VALLIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:COPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CCNS
Authorized Official - Phone:405-990-1200
Mailing Address - Street 1:2604 SW 91ST ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6708
Mailing Address - Country:US
Mailing Address - Phone:405-636-7000
Mailing Address - Fax:
Practice Address - Street 1:2604 SW 91ST ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6708
Practice Address - Country:US
Practice Address - Phone:405-378-2209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0079679282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital