Organization Active NPI

Hy-Vee Inc

Doing business as Hy-Vee Drugstore (7031)

  • Community/Retail Pharmacy
  • Des Moines, IA
National Provider Identifier
1023053543
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1126 Issued in IA
Legal business name
HY-VEE INC
Doing business as
Hy-Vee Drugstore (7031)
Practice address
4100 University Ave
Des Moines, IA 50311-3533
Phone
(515) 633-8606
Fax
(515) 633-8609
NPI assigned
Jun 18, 2006
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 1126 IA Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

4100 University Ave
Des Moines, IA 50311-3533

Mailing address

PO Box 850442
Minneapolis, MN 55485-0442
Phone (515) 267-2800

Other identifiers 2

IdentifierTypeStateIssuer
0209874MedicaidIA
1620574OtherIANCPDP

Other names 1

  • Hy-Vee Drugstore (7031) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031230000598 IA Part B Supplier - Mass Immunization (Roster Biller Only) 7416855242 This NPI is an additional NPI on the enrollment
Practice locations: Albia, IA
O20100930000373 IA DME Supplier - PharmacyDME Supplier - Orthotic PersonnelDME Supplier - Grocery Store 7416855242 Practice locations: Des Moines, IA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0993567Hy-Vee Drugstore #70314100 University Avenue, Des Moines, IA 50311Certificate of waiverJul 8, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hy-Vee Drugstore (7031)4100 University Ave, Des Moines, IA 50311-3511(515) 633-8606 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 assignmentParticipating since Dec 7, 2017

National Provider Directory

National Provider Directory
Tax ID family
Hy-Vee Pharmacy 1530278 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

4100 University Ave
Des Moines, IA 50311
Phone (515) 633-8603

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1023053543",
    "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": "4100 UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503113533",
            "telephone_number": "515-633-8606",
            "fax_number": "515-633-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HY-VEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "1126",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0209874",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1620574",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hy-Vee Drugstore (7031)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hy-Vee Drugstore (7031)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, 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.

Verify at the official NPI Registry.