Organization
HAC-INC
Active
Other names
Homeland
Organization subpart
No
Provider details
NPI number
Authorized official
TALITHA NICHOLS (DIRECTOR OF PHARMACY)
(405) 290-3423
Entity
Organization
Contact information
Practice address
390 NE 36TH, OKLAHOMA CITY, OK 73105
(405) 290-3423
(405) 290-3523
Mailing address
PO BOX 25008, OKLAHOMA CITY, OK 73125
(405) 290-3423
(405) 290-3523
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
7-5198
OK
3336C0003X
Community/Retail Pharmacy
Primary
7-5198
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247730R
—
OK
01
—
3719777
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/04/2006
Last updated
07/21/2022
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