MEDICARE: HY-VEE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy
2	3336C0003X	Community/Retail Pharmacy	1126	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1620574	OTHER	IA	NCPDP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023053543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HY-VEE INC

Provider Business Mailing Address
First Line	:	PO BOX 850442
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55485-0442
Country	:	US
Telephone Number	:	515-267-2800
Fax Number	:	515-559-2593

Provider Business Practice Location Address
First Line	:	4100 UNIVERSITY AVE
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50311-3533
Country	:	US
Telephone Number	:	515-633-8606
Fax Number	:	515-633-8609

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT
Name	:	ANGIE NELSON
Credential	:
Telephone Number	:	515-267-2800

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	10/04/2023

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Directions to “HY-VEE INC ” Practice Location

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