Organization
HAC, INC.
Active
Other names
Homeland Pharmacy #238
Organization subpart
No
Provider details
NPI number
Authorized official
JOSH MILLER (DIRECTOR OF PHARMACY)
(405) 290-3423
Entity
Organization
Contact information
Practice address
1151 N BRYANT AVE, EDMOND, OK 73034-3251
(405) 844-4404
Mailing address
PO BOX 25008, OKLAHOMA CITY, OK 73125
(405) 290-3423
(405) 290-3523
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
15353
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100247570E
MEDICAID DME
OK
05
—
100247570H
—
OK
01
—
3725439
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/26/2008
Last updated
05/11/2023
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