Organization
HAC, INC.
Active
Other names
Homeland
Organization subpart
No
Provider details
NPI number
Authorized official
JOSH MILLER (DIRECTOR OF PHARMACY)
(405) 290-3423
Entity
Organization
Contact information
Practice address
4129 SE 29TH ST, DEL CITY, OK 73115-2643
(405) 672-2180
Mailing address
PO BOX 25008, OKLAHOMA CITY, OK 73125
(405) 290-3423
(405) 290-3523
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
1-5352
OK
3336C0003X
Community/Retail Pharmacy
Primary
1-5352
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247570C
—
OK
01
—
100247570L
MEDICAID DME
OK
Enumeration date
11/24/2008
Last updated
05/11/2023
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