Active NPI
Hac, Inc.
- Pharmacy
- Bartlesville, OK
National Provider Identifier
1124065644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 9-5246
- Legal business name
- HAC, INC.
- Practice address
- 2501 S.E. Washington
Bartlesville, OK 74006 - Phone
- (918) 335-2020
- Fax
- (918) 335-2021
- NPI assigned
- Jun 1, 2006
- 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
- Josh Miller, D.PH.
- Title
- Director of Pharmacy
- Phone
- (405) 290-3423
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 9-5246 | OK | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
2501 S.E. Washington
Bartlesville, OK 74006
Mailing address
390 N.E. 36TH St.
Oklahoma City, OK 73105
Phone (405) 290-3421
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200114207N | Medicaid | OK | |
| 3718725 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 3718725 | Other | OK | NCPDP |
Other names 1
- Homeland Pharmacy #467
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.
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 |
|---|---|---|---|
| 37D2284627 | Homeland Pharmacy #467 | Certificate of waiver | Jun 26, 2027 |
National Provider Directory
National Provider Directory- Part of
- Hac-Inc
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": "1124065644",
"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": "2501 S.E. WASHINGTON",
"city": "BARTLESVILLE",
"state": "OK",
"postal_code": "74006",
"telephone_number": "918-335-2020",
"fax_number": "918-335-2021"
}
],
"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": "MILLER",
"authorized_official_first_name": "JOSH",
"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": "9-5246",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200114207N",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3718725",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3718725",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Homeland Pharmacy #467",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bartlesville, 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.