MEDICARE: H.A.C., 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	6-5247	OK
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3720732	OTHER	OK	NCPDP
2	3720732	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477592855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H.A.C., INC.

Provider Business Mailing Address
First Line	:	390 N.E. 36TH ST.
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73105
Country	:	US
Telephone Number	:	405-290-3421
Fax Number	:	405-290-3521

Provider Business Practice Location Address
First Line	:	2005 N. 14TH ST., STE, 110
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74601
Country	:	US
Telephone Number	:	580-762-7444
Fax Number	:	580-762-5110

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	TALITHA NICHOLS
Credential	:	D. PH.
Telephone Number	:	405-290-3423

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	12/02/2019

Similar Medicare Providers

1891635736 — ADA E MEHOJAH
Practice Location Address:

407 W SOUTH AVE
PONCA CITY, OK
74601-6133

Practice Phone: 844-458-2100
Practice Fax:

1447253737 — MARK EDWARD RIGNEY M.D.
Practice Location Address:

425 FAIRVIEW AVE STE 1
PONCA CITY, OK
74601-1924

Practice Phone: 580-765-6647
Practice Fax: 580-765-6699

1659376853 — DR. WILLIAM A STUEVER O.D.
Practice Location Address:

1619 N 5TH ST
PONCA CITY, OK
74601-2703

Practice Phone: 580-762-5700
Practice Fax: 580-765-3022

1053316737 — MR. PAUL DONOVAN MCAREAVEY RPT
Practice Location Address:

2005 N 14TH ST , STE 111
PONCA CITY, OK
74601-1952

Practice Phone: 580-765-0101
Practice Fax: 580-765-3434

1629073358 — MS. RAMONA ESTRADA PERALEZ RPT
Practice Location Address:

2005 N 14TH ST , STE 111
PONCA CITY, OK
74601-1952

Practice Phone: 580-765-0101
Practice Fax: 580-765-3434

1285639781 — PAMELA J POLAND M.D.
Practice Location Address:

400 FAIRVIEW AVE , STE 18
PONCA CITY, OK
74601-1920

Practice Phone: 580-762-5696
Practice Fax: 580-762-7622

1346246584 — JAMES MICHAEL REBIK D.O.
Practice Location Address:

421 E. HARTFORD AVE.
PONCA CITY, OK
74601

Practice Phone: 580-718-4502
Practice Fax: 580-765-2123

Directions to “H.A.C., INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.