Organization
HAC, INC.
Active
Other names
HOMELAND PHARMACY #616
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT K PESSEL (DIRECTOR OF PHARMACY)
(405) 290-3423
Entity
Organization
Contact information
Practice address
3330 NW 56TH ST, OKLAHOMA CITY, OK 73112-4479
(405) 917-9860
(405) 917-9823
Mailing address
390 NE 36TH ST, OKLAHOMA CITY, OK 73105-2508
(405) 290-3421
(405) 290-3521
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1-5858
OK
3336C0003X
Community/Retail Pharmacy
Primary
1-5858
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247730SV
—
OK
Enumeration date
02/28/2012
Last updated
01/03/2013
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