NPIMap

Organization Active NPI

H.a.C., Inc.

  • Community/Retail Pharmacy
  • Ponca City, OK
National Provider Identifier
1477592855
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
H.A.C., INC.
Practice address
2005 N. 14TH St., Ste, 110
Ponca City, OK 74601
Phone
(580) 762-7444
Fax
(580) 762-5110
NPI assigned
Jun 4, 2006
Organization subpart
Yes
Parent organization
H.A.C., INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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)CodeLicenseStatePrimary
Pharmacy 333600000X 6-5247 OK
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2005 N. 14TH St., Ste, 110
Ponca City, OK 74601

Mailing address

390 N.E. 36TH St.
Oklahoma City, OK 73105
Phone (405) 290-3421

Other identifiers 3

IdentifierTypeStateIssuer
3720732OtherOKNCPDP
3720732OtherOTHER ID NUMBER-COMMERCIAL NUMBER
20011427OPMedicaidOK

Other names 2

  • Homeland Pahrmacy #468 Doing business as
  • Pyramid Pharmacy #68 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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…
O20200424002512 OK DME Supplier - Pharmacy 6608083084 Practice locations: Ponca City, OK

Other NPIs with the same Medicare PAC ID 21

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 21

Other NPIs on the same Medicare enrollment 35

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 35

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Homeland Pharmacy #4682005 N 14TH St, Ponca City, OK 74601-1919(580) 762-7444 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jul 8, 2011

National Provider Directory

National Provider Directory
Tax ID family
Hac-Inc35 organizations share this tax ID, including this one
Part of
Hac-Inc

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Locations

2005 N 14th St
Ste 110
Ponca City, OK 74601
Phone (580) 762-7444

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1575244800000",
    "number": "1477592855",
    "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": "2005 N. 14TH ST., STE, 110",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "74601",
            "telephone_number": "580-762-7444",
            "fax_number": "580-762-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H.A.C., INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "H.A.C., INC.",
        "enumeration_date": "2006-06-04",
        "last_updated": "2019-12-02",
        "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": "6-5247",
            "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": "3720732",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3720732",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20011427OP",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homeland Pahrmacy #468",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pyramid Pharmacy #68",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.

Verify at the official NPI Registry.