Active NPI
Hac-Inc
- Community/Retail Pharmacy
- Oklahoma City, OK
National Provider Identifier
1740229129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 7-5198
- Legal business name
- HAC-INC
- Practice address
- 390 NE 36TH
Oklahoma City, OK 73105 - Phone
- (405) 290-3423
- Fax
- (405) 290-3523
- 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
- Talitha Nichols
- Title
- Director of Pharmacy
- Phone
- (405) 290-3423
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 7-5198 | OK | |
| Community/Retail Pharmacy | 3336C0003X | 7-5198 | OK | Primary |
Addresses
Primary practice location
390 NE 36TH
Oklahoma City, OK 73105
Mailing address
PO Box 25008
Oklahoma City, OK 73125
Phone (405) 290-3423
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3719777 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 100247730R | Medicaid | OK |
Other names 1
- Homeland
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 DirectoryNPI 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": "1658361600000",
"number": "1740229129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 25008",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73125",
"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": "390 NE 36TH",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73105",
"telephone_number": "405-290-3423",
"fax_number": "405-290-3523"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAC-INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-04",
"last_updated": "2022-07-21",
"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"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "OK",
"license": "7-5198",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "OK",
"license": "7-5198",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3719777",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100247730R",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Homeland",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.