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	183500000X	Pharmacist	18582	IA

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

General Provider Information

NPI Number	:	1902972847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HY-VEE INC

Provider Business Mailing Address
First Line	:	3994 NW URBANDALE DR
Second Line	:
City	:	URBANDALE
State	:	IA
Zip	:	50322-7922
Country	:	US
Telephone Number	:	515-278-0117
Fax Number	:	515-278-6165

Provider Business Practice Location Address
First Line	:	3994 NW URBANDALE DR
Second Line	:
City	:	URBANDALE
State	:	IA
Zip	:	50322-7922
Country	:	US
Telephone Number	:	515-278-0117
Fax Number	:	515-278-6165

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MR. MICHAEL AKIRA CUESTA
Credential	:	RPH
Telephone Number	:	515-278-0117

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	10/04/2023

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Directions to “HY-VEE INC ” Practice Location

Language	Start Address	Practice Location

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