Healthcare Provider Details

I. General information

NPI: 1720020142
Provider Name (Legal Business Name): HY-VEE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 S MARION RD
SIOUX FALLS SD
57106-3636
US

IV. Provider business mailing address

PO BOX 850442
MINNEAPOLIS MN
55485-0442
US

V. Phone/Fax

Practice location:
  • Phone: 605-361-3347
  • Fax: 605-361-3417
Mailing address:
  • Phone: 515-559-5780
  • Fax: 515-559-2593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number100-1809
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1001809
License Number StateSD

VIII. Authorized Official

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