Organization
HAC INC
Active
Other names
HOMELAND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD HINES (DIRECTOR OF PHARMACY)
(405) 216-2233
Entity
Organization
Contact information
Practice address
4308 SE 44TH ST, OKLAHOMA CITY, OK 73135-3002
(405) 672-2065
(405) 670-6893
Mailing address
HOMELAND STORES INC, PO BOX 25008, OKLAHOMA CITY, OK 73125-0008
(405) 216-2233
(405) 216-2283
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
014634
OK
3336C0003X
Community/Retail Pharmacy
Primary
014634
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247680A
—
OK
01
—
3717381
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
03/20/2007
Last updated
06/19/2008
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