NPIMap

Organization Active NPI

Hy-Vee Inc

  • Community/Retail Pharmacy
  • South Sioux City, NE
National Provider Identifier
1083650964
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2520 Issued in NE
Legal business name
HY-VEE INC
Practice address
2501 Cornhusker Dr
South Sioux City, NE 68776-3910
Phone
(402) 494-3021
Fax
(402) 494-4969
NPI assigned
Jun 21, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Angie Nelson
Title
Senior Vice President
Phone
(515) 267-2800

Other NPIs on the same Medicare enrollment 25

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

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

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 (1620)2501 Cornhusker Plaza, South Sioux City, NE 68776-3910(402) 494-3021 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20070817000562 NE Part B Supplier - Mass Immunization (Roster Biller Only) 7416855242 27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Omaha, NE; Papillion, NE; Plattsmouth, NE; South Sioux City, NE; West Point, NE; Columbus, NE; Fremont, NE; Grand Island, NE…
O20100930075745 NE DME Supplier - PharmacyDME Supplier - Grocery Store 7416855242 Practice locations: South Sioux City, NE

National Provider Directory

National Provider Directory
Tax ID family
Drug Town 7060 (278 organizations share this tax ID)

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 2520 NE
Community/Retail Pharmacy 3336C0003X 2520 NE Primary

Addresses

NPPES NPI Registry

Primary practice location

2501 Cornhusker Dr
South Sioux City, NE 68776-3910

Mailing address

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

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
0543124MedicaidIA
8531670MedicaidSD

Other names 1

NPPES NPI Registry
  • Hy-Vee Pharmacy (1620) Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 9, 2023.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1083650964",
    "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": "2501 CORNHUSKER DR",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763910",
            "telephone_number": "402-494-3021",
            "fax_number": "402-494-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HY-VEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "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": "NE",
            "license": "2520",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "2520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0543124",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8531670",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hy-Vee Pharmacy (1620)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hy-Vee Pharmacy (1620)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Sioux City, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.