Organization
HAC, INC.
Active
Other names
Homeland Pharmacy #236
Organization subpart
No
Provider details
NPI number
Authorized official
JOSH MILLER (DIRECTOR OF PHARMACY)
(405) 290-3423
Entity
Organization
Contact information
Practice address
2400 CORNWELL DR, YUKON, OK 73099-5804
(405) 354-7449
Mailing address
PO BOX 25008, OKLAHOMA CITY, OK 73125
(405) 290-3423
(405) 290-3523
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26-5351
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247570F
—
OK
01
—
100247570J
MEDICAID DME
OK
01
—
3725390
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/26/2008
Last updated
05/11/2023
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