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General NPI Number Information
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NPI Number | 1013783950
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Entity Type | Organization
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Legal Business Name | HY-VEE HEALTH PC
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Dates
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Enumeration Date | 12/01/2023
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 10810 FARNAM DR STE 110
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City | OMAHA
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State | NE
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Zip | 68154-3256
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Country | US
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Telephone | 515-695-3121
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Fax |
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Provider Business Mailing Address
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Address Line | 5820 WESTOWN PKWY
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City | WEST DES MOINES
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State | IA
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Zip | 50266-8223
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CMO
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Name | DANIEL S FICK
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Credential |
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Telephone | 515-225-2930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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