Active NPI
Hac, Inc.
- Community/Retail Pharmacy
- Oklahoma City, OK
National Provider Identifier
1841564523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 1-5858
- Legal business name
- HAC, INC.
- Practice address
- 3330 NW 56TH St
Oklahoma City, OK 73112-4479 - Phone
- (405) 917-9860
- Fax
- (405) 917-9823
- NPI assigned
- Feb 28, 2012
- 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
- Mr. Robert K Pessel
- Title
- Director of Pharmacy
- Phone
- (405) 290-3423
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 1-5858 | OK | |
| Community/Retail Pharmacy | 3336C0003X | 1-5858 | OK | Primary |
Addresses
Primary practice location
3330 NW 56TH St
Oklahoma City, OK 73112-4479
Mailing address
390 NE 36TH St
Oklahoma City, OK 73105-2508
Phone (405) 290-3421
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100247730SV | Medicaid | OK |
Other names 1
- HOMELAND PHARMACY #616
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": "1330387200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1357171200000",
"number": "1841564523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 NE 36TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731052508",
"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": "3330 NW 56TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731124479",
"telephone_number": "405-917-9860",
"fax_number": "405-917-9823"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2012-02-28",
"last_updated": "2013-01-03",
"status": "A",
"authorized_official_last_name": "PESSEL",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
"authorized_official_telephone_number": "405-290-3423",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "OK",
"license": "1-5858",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "OK",
"license": "1-5858",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100247730SV",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "HOMELAND PHARMACY #616",
"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 Jan 3, 2013; 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.