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
505 S CHICKASAW ST, PAULS VALLEY, OK 73075-4601
(405) 238-7505
Mailing address
PO BOX 25008, OKLAHOMA CITY, OK 73125
(405) 290-3423
(405) 290-3523
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
224636
OK
3336C0003X
Community/Retail Pharmacy
Primary
224636
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247690A
—
OK
01
—
3712797
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
03/20/2007
Last updated
05/11/2023
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