Active NPI
Hy-Vee Inc
Doing business as Hy-Vee Pharmacy #3 (1866)
- Community/Retail Pharmacy
- Waterloo, IA
National Provider Identifier
1093741357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 979
- Legal business name
- HY-VEE INC
- Doing business as
- Hy-Vee Pharmacy #3 (1866)
- Practice address
- 1422 Flammang Dr
Waterloo, IA 50702-4368 - Phone
- (319) 234-1774
- Fax
- (319) 233-4492
- NPI assigned
- Jun 25, 2006
- Last updated
- Apr 25, 2023
- 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 | 979 | IA | |
| Community/Retail Pharmacy | 3336C0003X | 979 | IA | Primary |
Addresses
Primary practice location
1422 Flammang Dr
Waterloo, IA 50702-4368
Mailing address
PO Box 850442
Minneapolis, MN 55485-0442
Phone (515) 267-2800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1617161 | Other | IA | NCPDP |
| 0096511 | Medicaid | IA |
Other names 1
- Hy-Vee Pharmacy #3 (1866)
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 2
| 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 |
| O20100930050587 | IA | DME Supplier - Pharmacy | 7416855242 | Practice locations: Waterloo, IA |
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 |
|---|---|---|---|
| 16D1077470 | Hy-Vee Pharmacy #3 - 1866 | Certificate of waiver | Jul 15, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Hy-Vee Pharmacy 3 (1866) | 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 Directory- Tax ID family
- Hy-Vee Pharmacy 1522
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Hy-Vee Pharmacy #2 (1888)
- Community/Retail Pharmacy
- West Des Moines, IA
- NPI 1023047479
-
dba Hy-Vee Pharmacy Fulfillment Mail Order
- Mail Order Pharmacy
- Des Moines, IA
- NPI 1053958348
Locations
1422 Flammang Dr
Waterloo, IA 50702
Phone (319) 234-1774
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Cedar Falls, IA
- NPI 1619682069
-
- Pharmacist
- Waterloo, IA
- NPI 1548646995
-
- Pharmacist
- Waterloo, IA
- NPI 1437637469
-
- Pharmacist
- Waterloo, IA
- NPI 1063145993
-
- Pharmacist
- Waterloo, IA
- NPI 1649803818
-
- Pharmacist
- Waterloo, IA
- NPI 1831310325
-
- Registered Dietitian
- Waterloo, IA
- NPI 1336551753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682380800000",
"number": "1093741357",
"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": "1422 FLAMMANG DR",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507024368",
"telephone_number": "319-234-1774",
"fax_number": "319-233-4492"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HY-VEE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-25",
"last_updated": "2023-04-25",
"certification_date": "2023-04-25",
"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": "979",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IA",
"license": "979",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "1617161",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0096511",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hy-Vee Pharmacy #3 (1866)",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Hy-Vee Pharmacy #3 (1866)",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.