- Enrollment id
- O20240105000583
- Enrollment state
- OK
- Provider type code
- 00-09
- Provider type text
- PART A PROVIDER - HOSPITAL
- Npi
- 1548047616
- Multiple npi flag
- N
- Ccn
- 370006
- Associate id
- 1052762820
- Organization name
- INTEGRIS HEALTH PONCA CITY HOSPITAL INC
- Doing business as name
- INTEGRIS HEALTH PONCA CITY HOSPITAL
- Incorporation date
- 2023-08-16
- Incorporation state
- OK
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 1900 N 14TH ST
- City
- PONCA CITY
- State
- OK
- Zip code
- 746012035
- Practice location type
- MAIN/PRIMARY HOSPITAL LOCATION
- Subgroup - general
- N
- Subgroup - acute care
- Y
- Subgroup - alcohol drug
- N
- Subgroup - childrens
- N
- Subgroup - long-term
- N
- Subgroup - psychiatric
- N
- Subgroup - rehabilitation
- N
- Subgroup - short-term
- N
- Subgroup - swing-bed approved
- N
- Subgroup - psychiatric unit
- N
- Subgroup - rehabilitation unit
- N
- Subgroup - specialty hospital
- N
- Subgroup - other
- N
- Reh conversion flag
- N