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NPI Code Detail

MEDICARE: HY-VEE HEALTH PC

MEDICARE: HY-VEE HEALTH PC
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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1396511226
Entity Type Code : Organization
Provider Name (Legal Business Name) : HY-VEE HEALTH PC
Provider Business Mailing Address
First Line : 5820 WESTOWN PKWY
Second Line :
City : WEST DES MOINES
State : IA
Zip : 50266-8223
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4605 FLEUR DR
Second Line :
City : DES MOINES
State : IA
Zip : 50321-2333
Country : US
Telephone Number : 515-225-2930
Fax Number :
Authorized Official
Title or Position : CMO
Name : DANIEL S FICK
Credential :
Telephone Number : 515-225-2930
Provider Enumeration Date : 12/01/2023
Last Update Date : 12/01/2023

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