Healthcare Provider Details

I. General information

NPI: 1700115086
Provider Name (Legal Business Name): HYVACS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2009
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10004 S 152ND ST SUITE C
OMAHA NE
68138-3930
US

IV. Provider business mailing address

10004 S 152ND ST SUITE C
OMAHA NE
68138-3930
US

V. Phone/Fax

Practice location:
  • Phone: 402-861-4938
  • Fax: 402-861-4941
Mailing address:
  • Phone: 402-861-4938
  • Fax: 402-861-4941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number400
License Number StateNE

VIII. Authorized Official

Name: KRISTIN WILLIAMS
Title or Position: PRESIDENT
Credential:
Phone: 515-267-2800