Organization Active NPI

Hy-Vee Inc

Doing business as Hy-Vee Pharmacy (1475)

  • Community/Retail Pharmacy
  • Osage Beach, MO
National Provider Identifier
1043248115
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2005009613 Issued in MO
Legal business name
HY-VEE INC
Doing business as
Hy-Vee Pharmacy (1475)
Practice address
929 Highway D
Osage Beach, MO 65065-3169
Phone
(573) 302-8383
Fax
(573) 302-8484
NPI assigned
Jun 29, 2006
Last updated
Nov 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 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
Durable Medical Equipment & Medical Supplies 332B00000X 2005009613 MO
Community/Retail Pharmacy 3336C0003X 2005009613 MO Primary

Addresses

Primary practice location

929 Highway D
Osage Beach, MO 65065-3169

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2635994OtherMONCPDP
606194306MedicaidMO

Other names 1

  • Hy-Vee Pharmacy (1475) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070312000079 MO Part B Supplier - Mass Immunization (Roster Biller Only) 7416855242 1 other NPI on this enrollment
Practice locations: Osage Beach, MO
O20100930037870 MO DME Supplier - PharmacyDME Supplier - Grocery Store 7416855242 Practice locations: Osage Beach, MO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hy-Vee Pharmacy (1475)929 Highway D, Osage Beach, MO 65065-3169(573) 302-8383 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|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|N… 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 12

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1043248115",
    "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": "929 HIGHWAY D",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653169",
            "telephone_number": "573-302-8383",
            "fax_number": "573-302-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HY-VEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "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": "MO",
            "license": "2005009613",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2005009613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2635994",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606194306",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hy-Vee Pharmacy (1475)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hy-Vee Pharmacy (1475)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osage Beach, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.