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
7001 NW 122ND ST, OKLAHOMA CITY, OK 73142-3924
(405) 720-9303
Mailing address
PO BOX 25008, OKLAHOMA CITY, OK 73125
(405) 290-3423
(405) 290-3523
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
1-5350
OK
3336C0003X
Community/Retail Pharmacy
Primary
1-5350
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247570G
—
OK
01
—
100247570K
MEDICAID DME
OK
Enumeration date
11/24/2008
Last updated
05/11/2023
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