Active NPI
Hac, Inc.
Doing business as Homeland Pharmacy #469
- Community/Retail Pharmacy
- Stillwater, OK
National Provider Identifier
1033156559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- HAC, INC.
- Doing business as
- Homeland Pharmacy #469
- Practice address
- 421 N. Main
Stillwater, OK 74075 - Phone
- (405) 743-1080
- Fax
- (405) 372-4872
- NPI assigned
- Jun 1, 2006
- Last updated
- May 11, 2023
- Organization subpart
- Yes
- Parent organization
- HAC INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Talitha Nichols, D.PH.
- Title
- Director of Pharmacy
- Phone
- (405) 290-3423
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 8-5248 | OK | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
421 N. Main
Stillwater, OK 74075
Mailing address
390 N.E. 36TH St.
Oklahoma City, OK 73105
Phone (405) 290-3421
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3719222 | Other | OK | NCPDP |
| 200114270R | Medicaid | OK | |
| 3719222 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- Homeland Pharmacy #469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 2
| 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… |
| O20200403002521 | OK | DME Supplier - Pharmacy | 6608083084 | Practice locations: Stillwater, OK |
Other NPIs with the same Medicare PAC ID 21
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Homeland Pahrmacy #468
- Community/Retail Pharmacy
- Ponca City, OK
- NPI 1477592855
6608083084
-
dba Homeland Pharmacy #495
- Community/Retail Pharmacy
- Henryetta, OK
- NPI 1033234125
6608083084
-
dba Homeland Pharmacy #153
- Community/Retail Pharmacy
- Oklahoma City, OK
- NPI 1417072505
6608083084
-
dba Homeland Pharmacy #195
- Community/Retail Pharmacy
- Oklahoma City, OK
- NPI 1629193719
6608083084
Other NPIs on the same Medicare enrollment 35
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba J & M Drug at Homeland
- Community/Retail Pharmacy
- Bartlesville, OK
- NPI 1710002803
O20110915000635
-
dba Homeland Pahrmacy #468
- Community/Retail Pharmacy
- Ponca City, OK
- NPI 1477592855
O20110915000635
-
dba Homeland Pharmacy #164
- Community/Retail Pharmacy
- Edmond, OK
- NPI 1598564635
O20110915000635
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D2284631 | Homeland Pharmacy #469 | Certificate of waiver | Jun 26, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Homeland Pharmacy #469 | Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Hac Inc
- Part of
- Hac Inc
Other organizations with this tax ID 34
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacy
- Oklahoma City, OK
- NPI 1346365434
Locations
421 N Main St
Stillwater, OK 74075
Phone (405) 743-1080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1683763200000",
"number": "1033156559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 N.E. 36TH ST.",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73105",
"telephone_number": "405-290-3421",
"fax_number": "405-290-3521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 N. MAIN",
"city": "STILLWATER",
"state": "OK",
"postal_code": "74075",
"telephone_number": "405-743-1080",
"fax_number": "405-372-4872"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAC, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HAC INC",
"enumeration_date": "2006-06-01",
"last_updated": "2023-05-11",
"certification_date": "2023-05-11",
"status": "A",
"authorized_official_last_name": "NICHOLS",
"authorized_official_first_name": "TALITHA",
"authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
"authorized_official_telephone_number": "405-290-3423",
"authorized_official_credential": "D.PH."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "OK",
"license": "8-5248",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3719222",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200114270R",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3719222",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Homeland Pharmacy #469",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Stillwater, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.