MEDICARE: HAC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	014632	OK
2	3336C0003X	Community/Retail Pharmacy	014632	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3712913	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1114042298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAC INC

Provider Business Mailing Address
First Line	:	390 NE 36TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73105-2508
Country	:	US
Telephone Number	:	405-290-3423
Fax Number	:	405-290-3523

Provider Business Practice Location Address
First Line	:	2016 NW 39TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-2614
Country	:	US
Telephone Number	:	405-521-9516
Fax Number	:	405-528-8729

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	HUNTER J HOGAN III
Credential	:
Telephone Number	:	405-290-3423

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	01/19/2010

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Directions to “HAC INC ” Practice Location

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