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Organization
HAC, INC.
Active
Organization
HAC, INC.
Active
Other names
PRICE CHOPPER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD HINES (DIRECTOR OF PHARMACY)
(405) 216-2233
Entity
Organization
Contact information
Practice address
3734 PEAR ST, SAINT JOSEPH, MO 64503-1507
(816) 236-2062
(816) 232-2064
Mailing address
PO BOX 25008, OKLAHOMA CITY, OK 73125-0008
(405) 216-2233
(405) 216-2283
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
2005041200
MO
3336C0003X
Community/Retail Pharmacy
2005041200
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200381320K
—
KS
01
—
2633205
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
604973107
—
MO
Enumeration date
07/22/2006
Last updated
05/15/2008
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