NPIMap

Organization Active NPI

Hac, Inc.

  • Pharmacy
  • Elk City, OK
National Provider Identifier
1992820088
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
354635 Issued in OK
Legal business name
HAC, INC.
Practice address
412 W 3Rd St
Elk City, OK 73644-5202
Phone
(580) 225-7961
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 354635 OK Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

412 W 3Rd St
Elk City, OK 73644-5202

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
3713244OtherOTHER ID NUMBER-COMMERCIAL NUMBER
100247700AMedicaidOK

Other names 1

  • Homeland Pharmacy #170 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930056645 OK DME Supplier - PharmacyDME Supplier - Grocery Store 6608083084 Practice locations: Elk City, 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
37D2064963Homeland Pharmacy #170412 W Third, Elk City, OK 73644Certificate of waiverAug 28, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Homeland Pharmacy #170412 W 3Rd St, Elk City, OK 73644-5202(580) 225-7961 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

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": "1992820088",
    "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": "412 W 3RD ST",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736445202",
            "telephone_number": "580-225-7961"
        }
    ],
    "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": "354635",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3713244",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247700A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homeland Pharmacy #170",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk City, 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.