NPIMap

Organization Active NPI

Hac, Inc.

  • Community/Retail Pharmacy
  • Ardmore, OK
National Provider Identifier
1801911995
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
124837 Issued in OK
Legal business name
HAC, INC.
Practice address
205 N Commerce St
Ardmore, OK 73401-3906
Phone
(580) 223-0143
NPI assigned
Mar 20, 2007
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 124837 OK
Community/Retail Pharmacy 3336C0003X 124837 OK Primary

Addresses

Primary practice location

205 N Commerce St
Ardmore, OK 73401-3906

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
100247730BMedicaidOK
3713270OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Homeland Pharmacy #169 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930004400 OK DME Supplier - PharmacyDME Supplier - Grocery Store 6608083084 Practice locations: Ardmore, 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
37D2071089Homeland Pharmacy #169205 N Commerce, Ardmore, OK 73401Certificate of waiverJan 1, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Homeland Pharmacy #169205 N Commerce St, Ardmore, OK 73401-3906(580) 223-0143 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

Locations

205 N Commerce St
Ardmore, OK 73401
Phone (580) 223-0143

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1683763200000",
    "number": "1801911995",
    "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": "205 N COMMERCE ST",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734013906",
            "telephone_number": "580-223-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "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": "124837",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "124837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247730B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3713270",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homeland Pharmacy #169",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ardmore, 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.