Active NPI
Hac Inc
- Community/Retail Pharmacy
- Muskogee, OK
National Provider Identifier
1003855487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 4-5195
- Legal business name
- HAC INC
- Practice address
- 2410 Chandler Rd
Muskogee, OK 74403-5001 - Phone
- (918) 686-6734
- Fax
- (918) 686-6739
- NPI assigned
- Jun 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hunter J Hogan III
- Title
- Director of Pharmacy
- Phone
- (405) 290-3423
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 4-5195 | OK | |
| Community/Retail Pharmacy | 3336C0003X | 4-5195 | OK | Primary |
Addresses
Primary practice location
2410 Chandler Rd
Muskogee, OK 74403-5001
Mailing address
390 NE 36TH St
Oklahoma City, OK 73105-2508
Phone (405) 290-3423
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100247730L | Medicaid | OK | |
| 3721176 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- N/A
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110915000635 | OK | Part B Supplier - Mass Immunization (Roster Biller Only) | 6608083084 |
35 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ponca City, OK; Oklahoma City, OK; Norman, OK; Henryetta, OK; Elk City, OK; El Reno, OK; Edmond, OK; Duncan, OK… |
Other NPIs on the same Medicare enrollment 35
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
2410 Chandler Rd
Muskogee, OK 74403
Phone (918) 686-6734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1263772800000",
"number": "1003855487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 NE 36TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731052508",
"telephone_number": "405-290-3423",
"fax_number": "405-290-3523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 CHANDLER RD",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744035001",
"telephone_number": "918-686-6734",
"fax_number": "918-686-6739"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAC INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-04",
"last_updated": "2010-01-18",
"status": "A",
"authorized_official_last_name": "HOGAN",
"authorized_official_first_name": "HUNTER",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
"authorized_official_telephone_number": "405-290-3423",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "OK",
"license": "4-5195",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "OK",
"license": "4-5195",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100247730L",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3721176",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "N/A",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.