Organization Active NPI

Hy-Vee Inc

Doing business as Hy-Vee Pharmacy #3 (1510)

  • Community/Retail Pharmacy
  • Overland Park, KS
National Provider Identifier
1326083965
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8878 Issued in KS
Legal business name
HY-VEE INC
Doing business as
Hy-Vee Pharmacy #3 (1510)
Practice address
6801 W 91St St
Overland Park, KS 66212-1459
Phone
(913) 385-7373
Fax
(913) 385-5126
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
Mr. Robert G. Egeland, R.PH.
Title
Vice President, Pharmacy
Phone
(515) 453-2784

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 209624 KS
Community/Retail Pharmacy 3336C0003X 8878 KS Primary

Addresses

Primary practice location

6801 W 91St St
Overland Park, KS 66212-1459

Mailing address

PO Box 61
Cherokee, IA 51012-0061
Phone (712) 225-1903

Other identifiers 2

IdentifierTypeStateIssuer
1716349OtherKSNCPDP
100433500AMedicaidKS

Other names 1

  • Hy-Vee Pharmacy #3 (1510) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050712001041 KS Part B Supplier - Mass Immunization (Roster Biller Only) 7416855242 13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Overland Park, KS; Topeka, KS; Shawnee, KS; Prairie Village, KS; Olathe, KS; Mission, KS; Manhattan, KS; Lenexa, KS…

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Locations

6801 W 91st St
Overland Park, KS 66212
Phone (913) 385-7373

Practitioners & affiliated clinicians

Practitioners 2

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": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1326083965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61",
            "city": "CHEROKEE",
            "state": "IA",
            "postal_code": "510120061",
            "telephone_number": "712-225-1903",
            "fax_number": "712-225-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 W 91ST ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121459",
            "telephone_number": "913-385-7373",
            "fax_number": "913-385-5126"
        }
    ],
    "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": "EGELAND",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "VICE PRESIDENT, PHARMACY",
        "authorized_official_telephone_number": "515-453-2784",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KS",
            "license": "209624",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "8878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1716349",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100433500A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hy-Vee Pharmacy #3 (1510)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hy-Vee Pharmacy #3 (1510)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overland Park, KS

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.