Healthcare Provider Details

I. General information

NPI: 1316277874
Provider Name (Legal Business Name): HY-VEE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 L ST
OMAHA NE
68107-2565
US

IV. Provider business mailing address

PO BOX 61
CHEROKEE IA
51012-0061
US

V. Phone/Fax

Practice location:
  • Phone: 402-731-9971
  • Fax: 402-731-8367
Mailing address:
  • Phone: 712-225-5706
  • Fax: 712-225-5700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2004
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number2004
License Number StateNE

VIII. Authorized Official

Name: ROBERT EGELAND
Title or Position: V. PRESIDENT, PHARMACY
Credential:
Phone: 515-453-2784