Active NPI
Hy-Vee Inc
Doing business as Hy-Vee Pharmacy #4 (1512)
- Community/Retail Pharmacy
- Overland Park, KS
National Provider Identifier
1669408050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 8908
- Legal business name
- HY-VEE INC
- Doing business as
- Hy-Vee Pharmacy #4 (1512)
- Practice address
- 10118 W 119TH St
Overland Park, KS 66213-1600 - Phone
- (913) 491-6261
- Fax
- (913) 491-6293
- NPI assigned
- Jun 25, 2006
- Last updated
- Oct 4, 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
- Mr. Robert G. Egeland, R.PH.
- Title
- Asst. Vice President, Pharmacy
- Phone
- (515) 453-2784
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 8908 | KS | Primary |
Addresses
Primary practice location
10118 W 119TH St
Overland Park, KS 66213-1600
Mailing address
5820 Westown Pkwy
West Des Moines, IA 50266-8223
Phone (515) 453-2784
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100433400A | Medicaid | KS |
Other names 1
- Hy-Vee Pharmacy #4 (1512)
National Provider Directory
National Provider Directory- Tax ID family
- Hy-Vee Pharmacy 1522
Organizations with this tax ID in the same state 10
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Locations
10118 W 119th St
Overland Park, KS 66213
Phone (913) 491-6261
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": "1696377600000",
"number": "1669408050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5820 WESTOWN PKWY",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502668223",
"telephone_number": "515-453-2784",
"fax_number": "515-327-2162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10118 W 119TH ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662131600",
"telephone_number": "913-491-6261",
"fax_number": "913-491-6293"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HY-VEE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-25",
"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": "ASST. VICE PRESIDENT, PHARMACY",
"authorized_official_telephone_number": "515-453-2784",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "R.PH."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "KS",
"license": "8908",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100433400A",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hy-Vee Pharmacy #4 (1512)",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Hy-Vee Pharmacy #4 (1512)",
"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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.