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	3336C0003X	Community/Retail Pharmacy
2	333600000X	Pharmacy	354635	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3713244	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992820088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAC, INC.

Provider Business Mailing Address
First Line	:	PO BOX 25008
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73125
Country	:	US
Telephone Number	:	405-290-3423
Fax Number	:	405-290-3523

Provider Business Practice Location Address
First Line	:	412 W 3RD ST
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-5202
Country	:	US
Telephone Number	:	580-225-7961
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	JOSH MILLER
Credential	:
Telephone Number	:	405-290-3423

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	05/11/2023

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Directions to “HAC, INC. ” Practice Location

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