NPIMap

Organization Active NPI

Hy-Vee Inc

Doing business as Hy-Vee Pharmacy #2 (1216)

  • Community/Retail Pharmacy
  • Galesburg, IL
National Provider Identifier
1235164146
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
54013888 Issued in IL
Legal business name
HY-VEE INC
Doing business as
Hy-Vee Pharmacy #2 (1216)
Practice address
2030 E Main St
Galesburg, IL 61401-5460
Phone
(309) 342-1619
Fax
(309) 342-2993
NPI assigned
Jul 11, 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
Durable Medical Equipment & Medical Supplies 332B00000X 54013888 IL
Community/Retail Pharmacy 3336C0003X 54013888 IL Primary

Addresses

Primary practice location

2030 E Main St
Galesburg, IL 61401-5460

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1468607OtherILNCPDP

Other names 1

  • Hy-Vee Pharmacy #2 (1216) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051213000438 IL Part B Supplier - Mass Immunization (Roster Biller Only) 7416855242 18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sycamore, IL; Springfield, IL; Silvis, IL; Rock Island, IL; Quincy, IL; Peru, IL; Peoria, IL; Moline, IL…
O20100930030929 IL DME Supplier - PharmacyDME Supplier - Grocery Store 7416855242 Practice locations: Galesburg, IL

Other NPIs on the same Medicare enrollment 17

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

View all 17

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
14D2045675Hy-Vee Pharmacy #12162030 E Main St, Galesburg, IL 61401Certificate of waiverAug 16, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hyvee Pharmacy #2 (1216)2030 E Main St, Galesburg, IL 61401-5460(309) 342-1619 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 1522278 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

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

  • Hy-Vee Inc

    dba Hy Vee Pharmacy (1047)

    • Community/Retail Pharmacy
    • Canton, IL
    • NPI 1023175338
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy #1 (1533)

    • Community/Retail Pharmacy
    • Quincy, IL
    • NPI 1134158934
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy (1642)

    • Community/Retail Pharmacy
    • Sycamore, IL
    • NPI 1215227673
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy (1600)

    • Community/Retail Pharmacy
    • Silvis, IL
    • NPI 1275562092
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy (1549)

    • Community/Retail Pharmacy
    • Rock Island, IL
    • NPI 1285676791
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy (1416)

    • Community/Retail Pharmacy
    • Moline, IL
    • NPI 1346279130
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy (1525)

    • Community/Retail Pharmacy
    • Peru, IL
    • NPI 1437195161
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy (1420)

    • Community/Retail Pharmacy
    • Macomb, IL
    • NPI 1679502462
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy 1298

    • Community/Retail Pharmacy
    • Jacksonville, IL
    • NPI 1700613080
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy (1519)

    • Community/Retail Pharmacy
    • Peoria, IL
    • NPI 1730490673
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy #2 (1534)

    • Community/Retail Pharmacy
    • Quincy, IL
    • NPI 1750310579
    NPD tax ID
  • Hy-Vee Inc

    dba Hy-Vee Pharmacy (1415)

    • Community/Retail Pharmacy
    • Milan, IL
    • NPI 1821027616
    NPD tax ID
View all 15

Locations

2030 E Main St
Galesburg, IL 61401
Phone (309) 342-1619

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1235164146",
    "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": "2030 E MAIN ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614015460",
            "telephone_number": "309-342-1619",
            "fax_number": "309-342-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HY-VEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "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": "IL",
            "license": "54013888",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "54013888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1468607",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hy-Vee Pharmacy #2 (1216)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hy-Vee Pharmacy #2 (1216)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Galesburg, IL

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.