Organization Active NPI

Hy-Vee Inc

  • Community/Retail Pharmacy
  • Spencer, IA
National Provider Identifier
1659307239
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1180 Issued in IA
Legal business name
HY-VEE INC
Practice address
819 Grand Ave
Spencer, IA 51301-3640
Phone
(712) 262-5611
Fax
(712) 262-2092
NPI assigned
Jun 24, 2006
Organization subpart
No

Authorized official

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

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
16D1091421Hy-Vee Pharmacy #1636819 Grand Avenue, Spencer, IA 51301Certificate of waiverOct 30, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hy Vee Pharmacy 1636819 Grand Ave, Spencer, IA 51301-3640(712) 262-5611 Epoetin|Immunosuppressive Drugs|Infusion 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/or Supplies|Surgi… Does not accept assignmentParticipating since Dec 7, 2017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

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
O20100930060022 IA DME Supplier - PharmacyDME Supplier - Grocery Store 7416855242 Practice locations: Spencer, IA

National Provider Directory

National Provider Directory
Tax ID family
Drug Town 7060278 organizations share this tax ID, including this one

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.

View all 24

Locations

819 Grand Ave
Spencer, IA 51301
Phone (712) 262-5611

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1180 IA
Community/Retail Pharmacy 3336C0003X 1180 IA Primary
Long Term Care Pharmacy 3336L0003X 1180 IA

Addresses

NPPES NPI Registry

Primary practice location

819 Grand Ave
Spencer, IA 51301-3640

Mailing address

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

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
0255232MedicaidIA
1621196OtherIANCPDP

Other names 1

NPPES NPI Registry
  • Hy-Vee Pharmacy (1636) 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 Oct 4, 2023.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1659307239",
    "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": "819 GRAND AVE",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513013640",
            "telephone_number": "712-262-5611",
            "fax_number": "712-262-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HY-VEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "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": "IA",
            "license": "1180",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "1180",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IA",
            "license": "1180",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0255232",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1621196",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hy-Vee Pharmacy (1636)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hy-Vee Pharmacy (1636)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spencer, IA

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.