HPC LLC

Provider Demographics

• NPI: 1174584544
• Name: HPC LLC
• Entity type: Organization
• Organization Name: HPC LLC
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: CHIEF OPERATIONS OFFICER
• Authorized Official - First Name: RICHARD
• Authorized Official - Middle Name: A
• Authorized Official - Last Name: HOOVER
• Authorized Official - Phone: 800-757-9192
• Mailing Address - Street 1: 6423 SHELBY VIEW DR STE 104
• Mailing Address - City: MEMPHIS
• Mailing Address - State: TN
• Mailing Address - Zip Code: 38134-7614
• Mailing Address - Country: US
• Mailing Address - Phone: 800-757-9192
• Mailing Address - Fax: 855-813-0583
• Practice Address - Street 1: 576 AZALEA RD STE 100
• Practice Address - City: MOBILE
• Practice Address - State: AL
• Practice Address - Zip Code: 36609-1516
• Practice Address - Country: US
• Practice Address - Phone: 800-757-9192
• Practice Address - Fax: 855-813-0583
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-03-28
• Last Update Date: 2023-06-28

Provider Licenses

State	License ID	Taxonomies
		333600000X, 3336H0001X, 3336M0002X
IA	3748	3336C0003X, 3336C0003X
IN	64000960A	3336C0003X
IL	054.016622	3336C0003X
KS	22-44599	3336C0003X
CT	PCN.0002086	3336C0003X
AK	PHAO1472	3336C0003X
MD	P05525	3336C0003X
GA	PHNR000332	3336C0003X
FL	PH24108	3336C0003X
HI	616	3336C0003X
KY	AL1350	3336C0003X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	3336C0003X	Suppliers	Pharmacy	Community/Retail Pharmacy
No	333600000X	Suppliers	Pharmacy
No	3336H0001X	Suppliers	Pharmacy	Home Infusion Therapy Pharmacy
No	3336M0002X	Suppliers	Pharmacy	Mail Order Pharmacy

Provider Identifiers

State	Identifier ID	ID Type	Issuer
FL	0263338000	Medicaid
OK	200095810A	Medicaid
KS	200620280A	Medicaid
NM	17483328	Medicaid
TN	1750533816	Medicaid
IN	200976170A	Medicaid
AZ	481719	Medicaid
KY	7100090010	Medicaid
AL	110458	Medicaid
TN	4582502	Medicaid
AL	1174584544	Medicaid
LA	2200968	Medicaid
AK	PH002AL	Medicaid
	1995226	Other	PK
SC	7A2285	Medicaid
	1995226	Other	PK
MN	1174584544	Medicaid
KY	7100090010	Medicaid
MD	0399337	Medicaid
LA	2200968	Medicaid
AZ	481719	Medicaid
AK	PH002AL	Medicaid
KS	200620280A	Medicaid
AK	PH002AL	Medicaid
FL	0263338000	Medicaid