Active NPI
Hac Inc
- Community/Retail Pharmacy
- Edmond, OK
National Provider Identifier
1104941293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 014650
- Legal business name
- HAC INC
- Practice address
- 24 E 33Rd St
Edmond, OK 73013-4603 - Phone
- (405) 330-7202
- Fax
- (405) 330-7242
- NPI assigned
- Mar 20, 2007
- 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 | 014650 | OK | |
| Community/Retail Pharmacy | 3336C0003X | 014650 | OK | Primary |
Addresses
Primary practice location
24 E 33Rd St
Edmond, OK 73013-4603
Mailing address
390 NE 36TH St
Oklahoma City, OK 73105-2508
Phone (405) 290-3423
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3720148 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 100247590A | Medicaid | OK |
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
24 E 33rd St
Edmond, OK 73013
Phone (405) 330-7202
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1262995200000",
"number": "1104941293",
"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": "24 E 33RD ST",
"city": "EDMOND",
"state": "OK",
"postal_code": "730134603",
"telephone_number": "405-330-7202",
"fax_number": "405-330-7242"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAC INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-20",
"last_updated": "2010-01-09",
"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": "014650",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "OK",
"license": "014650",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3720148",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100247590A",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "N/A",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.