Organization
HAC INC
Active
Other names
HOMELAND PHARMCY
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD HINES (DIRECTOR OF PHAMARCY)
(405) 216-2233
Entity
Organization
Contact information
Practice address
1607 S GEORGETOWN ST, WICHITA, KS 67218-4111
(316) 687-0200
(316) 687-3801
Mailing address
PO BOX 25008, HOMELAND STORES INC, OKLAHOMA CITY, OK 73125-0008
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
209797
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1717757
OTHER ID NUMBER
—
05
—
200381320O
—
KS
Enumeration date
03/20/2007
Last updated
09/12/2007
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