NPIMap

Organization Active NPI

Hy-Vee Inc

Doing business as Hy-Vee Pharmacy #3 (1889)

  • Community/Retail Pharmacy
  • West Des Moines, IA
National Provider Identifier
1598792160
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1026 Issued in IA
Legal business name
HY-VEE INC
Doing business as
Hy-Vee Pharmacy #3 (1889)
Practice address
1725 Jordan Creek Pkwy
West Des Moines, IA 50266-5876
Phone
(515) 226-8921
Fax
(515) 221-9355
NPI assigned
Jun 27, 2006
Last updated
Apr 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 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 1026 IA
Community/Retail Pharmacy 3336C0003X 1026 IA Primary

Addresses

Primary practice location

1725 Jordan Creek Pkwy
West Des Moines, IA 50266-5876

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
0166447MedicaidIA
I9929OtherIAMEDICARE LAB BILLING
1618985OtherIANCPDP

Other names 1

  • Hy-Vee Pharmacy #3 (1889) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031230000598 IA Part B Supplier - Mass Immunization (Roster Biller Only) 7416855242 This NPI is an additional NPI on the enrollment
Practice locations: Albia, IA
O20050224001012 IA Part B Supplier - Clinic/Group Practice 7416855242 Receives reassigned benefits from 2 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20100930075712 IA DME Supplier - PharmacyDME Supplier - Grocery Store 7416855242 Practice locations: West Des Moines, IA

Other NPIs on the same Medicare enrollment 7

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0970989Hy-Vee Pharmacy #3 - 18891725 Jordan Creek Parkway, West Des Moines, IA 50266Certificate of waiverFeb 29, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hy-Vee Pharmacy 3 (1889)1725 Jordan Creek Pkwy, West Des Moines, IA 50266-5876(515) 226-8921 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

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1598792160",
    "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": "1725 JORDAN CREEK PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665876",
            "telephone_number": "515-226-8921",
            "fax_number": "515-221-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HY-VEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "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": "1026",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "1026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166447",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LAB BILLING",
            "identifier": "I9929",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1618985",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hy-Vee Pharmacy #3 (1889)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hy-Vee Pharmacy #3 (1889)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Des Moines, 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.

Verify at the official NPI Registry.