NPIMap

Organization Active NPI

Hac, Inc.

  • Community/Retail Pharmacy
  • Bethany, OK
National Provider Identifier
1790722122
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
01-5192 Issued in OK
Legal business name
HAC, INC.
Practice address
7101 NW 23Rd St
Bethany, OK 73008-5129
Phone
(405) 789-2596
NPI assigned
Jun 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Josh Miller
Title
Director of Pharmacy
Phone
(405) 290-3423

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 1-5192 OK
Community/Retail Pharmacy 3336C0003X 01-5192 OK Primary

Addresses

Primary practice location

7101 NW 23Rd St
Bethany, OK 73008-5129

Mailing address

PO Box 25008
Oklahoma City, OK 73125
Phone (405) 290-3423

Other identifiers 2

IdentifierTypeStateIssuer
3718686OtherOTHER ID NUMBER-COMMERCIAL NUMBER
100247730FMedicaidOK

Other names 1

  • Homeland Pharmacy #217 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930035983 OK DME Supplier - PharmacyDME Supplier - Grocery Store 6608083084 Practice locations: Bethany, OK
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 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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2071147Homeland Pharmacy #2177101 NW 23Rd, Bethany, OK 73008Certificate of waiverJan 2, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Homeland Pharmacy #2177101 NW 23Rd St, Bethany, OK 73008-5159(405) 879-2596 Epoetin|Immunosuppressive Drugs|Infusion 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

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1790722122",
    "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": "7101 NW 23RD ST",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730085129",
            "telephone_number": "405-789-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "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"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OK",
            "license": "1-5192",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "01-5192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3718686",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247730F",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homeland Pharmacy #217",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethany, 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.

Verify at the official NPI Registry.