Active NPI
Hy-Vee Inc
- Community/Retail Pharmacy
- Burlington, IA
National Provider Identifier
1003852997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 475
- Legal business name
- HY-VEE INC
- Practice address
- 939 Angular St
Burlington, IA 52601-3918 - Phone
- (319) 753-0112
- Fax
- (319) 753-0113
- NPI assigned
- Jun 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Angie Nelson
- Title
- Senior Vice President
- Phone
- (515) 267-2800
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 475 | IA | |
| Community/Retail Pharmacy | 3336C0003X | 475 | IA | Primary |
Addresses
Primary practice location
939 Angular St
Burlington, IA 52601-3918
Mailing address
PO Box 850442
Minneapolis, MN 55485-0442
Phone (515) 267-2800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1620790 | Other | IA | NCPDP |
| 0224196 | Medicaid | IA |
Other names 1
- Hy-Vee Pharmacy #1 (1042)
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA, MN
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031230000598 | IA | Part B Supplier - Mass Immunization (Roster Biller Only) | 7416855242 |
This NPI is an additional NPI on the enrollment Practice locations: Albia, IA |
| O20040701000521 | MN | Part B Supplier - Mass Immunization (Roster Biller Only) | 7416855242 |
44 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Plymouth, MN; Preston, MN; Robbinsdale, MN; Rochester, MN; Saint Charles, MN; Saint Peter, MN; Savage, MN; Shakopee, MN… |
| O20100930012890 | IA | DME Supplier - Pharmacy | 7416855242 | Practice locations: Burlington, IA |
Other NPIs on the same Medicare enrollment 42
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D1009731 | Hy-Vee Pharmacy #1 - 1042 | Certificate of waiver | Sep 19, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Hy Vee Pharmacy #1 1042 | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Nebulizer Equipment and/o… | Does not accept assignment |
National Provider Directory
National Provider DirectoryLocations
939 Angular St
Burlington, IA 52601
Phone (319) 753-0112
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696377600000",
"number": "1003852997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 850442",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554850442",
"telephone_number": "515-267-2800",
"fax_number": "515-559-2593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 ANGULAR ST",
"city": "BURLINGTON",
"state": "IA",
"postal_code": "526013918",
"telephone_number": "319-753-0112",
"fax_number": "319-753-0113"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HY-VEE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-21",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A",
"authorized_official_last_name": "NELSON",
"authorized_official_first_name": "ANGIE",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
"authorized_official_telephone_number": "515-267-2800"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "IA",
"license": "475",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IA",
"license": "475",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "1620790",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0224196",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hy-Vee Pharmacy #1 (1042)",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Hy-Vee Pharmacy #1 (1042)",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Burlington, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.