MEDICARE: HY-VEE 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	332B00000X	Durable Medical Equipment & Medical Supplies	261655-7	MN
2	3336C0003X	Community/Retail Pharmacy	261655-7	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2423072	OTHER	MN	NCPDP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356370019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HY-VEE INC

Provider Business Mailing Address
First Line	:	PO BOX 850442
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55485-0442
Country	:	US
Telephone Number	:	515-267-2800
Fax Number	:	515-559-2593

Provider Business Practice Location Address
First Line	:	1307 18TH AVE NW
Second Line	:
City	:	AUSTIN
State	:	MN
Zip	:	55912-1857
Country	:	US
Telephone Number	:	507-437-9185
Fax Number	:	507-437-9198

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT
Name	:	ANGIE NELSON
Credential	:
Telephone Number	:	515-267-2800

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	07/17/2023

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Directions to “HY-VEE INC ” Practice Location

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