Healthcare Provider Details

I. General information

NPI: 1124065644
Provider Name (Legal Business Name): HAC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 S.E. WASHINGTON
BARTLESVILLE OK
74006
US

IV. Provider business mailing address

390 N.E. 36TH ST.
OKLAHOMA CITY OK
73105
US

V. Phone/Fax

Practice location:
  • Phone: 918-335-2020
  • Fax: 918-335-2021
Mailing address:
  • Phone: 405-290-3421
  • Fax: 405-290-3521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number9-5246
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOSH MILLER
Title or Position: DIRECTOR OF PHARMACY
Credential: D.PH.
Phone: 405-290-3423