Healthcare Provider Details

I. General information

NPI: 1477066710
Provider Name (Legal Business Name): HY-VEE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2017
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 10TH AVE
MANSON IA
50563-5051
US

IV. Provider business mailing address

PO BOX 850442
MINNEAPOLIS MN
55485-0442
US

V. Phone/Fax

Practice location:
  • Phone: 712-469-2214
  • Fax: 712-469-2317
Mailing address:
  • Phone: 515-453-2796
  • Fax: 515-559-2486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateIA

VIII. Authorized Official

Name: ANGIE NELSON
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 515-267-2800