Public record

CMS Hospital All Owners

Associate id: 1052762820 · 32 matching records

Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
1951663178
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-10-31
First name - owner
DONNA
Middle name - owner
M
Last name - owner
WALLACE
Title - owner
ASSISTANT TREASURER
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
2769765379
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2023-08-16
First name - owner
MICHAEL
Middle name - owner
L
Last name - owner
WEED
Title - owner
TREASURER
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
2769765379
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-10-31
First name - owner
MICHAEL
Middle name - owner
L
Last name - owner
WEED
Title - owner
TREASURER
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
2769765379
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-08-16
First name - owner
MICHAEL
Middle name - owner
L
Last name - owner
WEED
Title - owner
TREASURER
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
3779549811
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-08-16
Organization name - owner
INTEGRIS HEALTH INC
Doing business as name - owner
INTEGRIS HEALTH INC
Address line 1 - owner
3001 QUAIL SPRINGS PKWY
Address line 2 - owner
FL 3
City - owner
OKLAHOMA CITY
State - owner
OK
Zip code - owner
731342640
Corporation - owner
Y
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
Y
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
4082887856
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2023-08-16
First name - owner
BRENT
Last name - owner
HUBBARD
Title - owner
SENIOR VICE PRESIDENT & COO
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
4082887856
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-10-31
First name - owner
BRENT
Last name - owner
HUBBARD
Title - owner
SENIOR VICE PRESIDENT & COO
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
4082887856
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-08-16
First name - owner
BRENT
Last name - owner
HUBBARD
Title - owner
SENIOR VICE PRESIDENT & COO
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335031533
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2023-08-16
First name - owner
TIMOTHY
Last name - owner
PEHRSON
Title - owner
PRESIDENT & CEO
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335031533
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-10-31
First name - owner
TIMOTHY
Last name - owner
PEHRSON
Title - owner
PRESIDENT & CEO
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335031533
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2023-08-16
First name - owner
TIMOTHY
Last name - owner
PEHRSON
Title - owner
PRESIDENT & CEO
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335031533
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-08-16
First name - owner
TIMOTHY
Last name - owner
PEHRSON
Title - owner
PRESIDENT & CEO
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335031533
Type - owner
I
Role code - owner
44
Role text - owner
OTHER
Association date - owner
2023-11-01
First name - owner
TIMOTHY
Last name - owner
PEHRSON
Title - owner
CHAIN HOME OFFICE ADMINISTRATOR
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335424050
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2023-11-01
First name - owner
CHRISTOPHER
Last name - owner
MENDOZA
Title - owner
CHIEF HOSPITAL EXECUTIVE
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335424050
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-11-01
First name - owner
CHRISTOPHER
Last name - owner
MENDOZA
Title - owner
CHIEF HOSPITAL EXECUTIVE
Enrollment id
O20240105000583
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335424050
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-11-01
First name - owner
CHRISTOPHER
Last name - owner
MENDOZA
Title - owner
CHIEF HOSPITAL EXECUTIVE
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
1951663178
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-10-31
First name - owner
DONNA
Middle name - owner
M
Last name - owner
WALLACE
Title - owner
ASSISTANT TREASURER
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
2769765379
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2023-08-16
First name - owner
MICHAEL
Middle name - owner
L
Last name - owner
WEED
Title - owner
TREASURER
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
2769765379
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-10-31
First name - owner
MICHAEL
Middle name - owner
L
Last name - owner
WEED
Title - owner
TREASURER
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
2769765379
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-08-16
First name - owner
MICHAEL
Middle name - owner
L
Last name - owner
WEED
Title - owner
TREASURER
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
3779549811
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-08-16
Organization name - owner
INTEGRIS HEALTH INC
Doing business as name - owner
INTEGRIS HEALTH INC
Address line 1 - owner
3001 QUAIL SPRINGS PKWY
Address line 2 - owner
FL 3
City - owner
OKLAHOMA CITY
State - owner
OK
Zip code - owner
731342640
Corporation - owner
Y
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
Y
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
4082887856
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2023-08-16
First name - owner
BRENT
Last name - owner
HUBBARD
Title - owner
SENIOR VICE PRESIDENT & COO
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
4082887856
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-10-31
First name - owner
BRENT
Last name - owner
HUBBARD
Title - owner
SENIOR VICE PRESIDENT & COO
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
4082887856
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-08-16
First name - owner
BRENT
Last name - owner
HUBBARD
Title - owner
SENIOR VICE PRESIDENT & COO
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335031533
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2023-08-16
First name - owner
TIMOTHY
Last name - owner
PEHRSON
Title - owner
PRESIDENT & CEO
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335031533
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-10-31
First name - owner
TIMOTHY
Last name - owner
PEHRSON
Title - owner
PRESIDENT & CEO
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335031533
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2023-08-16
First name - owner
TIMOTHY
Last name - owner
PEHRSON
Title - owner
PRESIDENT & CEO
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335031533
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-08-16
First name - owner
TIMOTHY
Last name - owner
PEHRSON
Title - owner
PRESIDENT & CEO
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335031533
Type - owner
I
Role code - owner
44
Role text - owner
OTHER
Association date - owner
2023-11-01
First name - owner
TIMOTHY
Last name - owner
PEHRSON
Title - owner
CHAIN HOME OFFICE ADMINISTRATOR
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335424050
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2023-11-01
First name - owner
CHRISTOPHER
Last name - owner
MENDOZA
Title - owner
CHIEF HOSPITAL EXECUTIVE
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335424050
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-11-01
First name - owner
CHRISTOPHER
Last name - owner
MENDOZA
Title - owner
CHIEF HOSPITAL EXECUTIVE
Enrollment id
O20240105000816
Associate id
1052762820
Organization name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Associate id - owner
9335424050
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-11-01
First name - owner
CHRISTOPHER
Last name - owner
MENDOZA
Title - owner
CHIEF HOSPITAL EXECUTIVE

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