Hy-Vee Inc
Organization Active NPI Community/Retail Pharmacy · Corydon, IA
NPI 1669887642 · NPPES record last updated Oct 4, 2023
Key facts
- NPI
- 1669887642
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 1510 (IA)
- Legal business name
- HY-VEE INC
- Practice address
- 105 E Jackson St
Corydon, IA 50060-1408 - Phone
- (641) 872-2512
- Fax
- (641) 872-1078
- NPI assigned
- Jun 27, 2014
- Organization subpart
- No
Authorized official
- Name
- Angie Nelson
- Title
- Senior Vice President
- Phone
- (515) 267-2800
Corporate family (same tax ID) 24
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2041197 | Hy-Vee Pharmacy #1089 | Certificate of waiver | Dec 21, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Hy-Vee Pharmacy (1089) |
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 assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031230000598 | IA | Part B Supplier - Mass Immunization (Roster Biller Only) | 7416855242 |
This NPI is an additional NPI on the enrollment Practice locations: Albia, IA |
| O20141013000604 | IA | DME Supplier - Pharmacy | 7416855242 | Practice locations: Corydon, IA |
National Provider Directory
- Tax ID family
- Drug Town 7060
Locations
105 E Jackson St
Corydon, IA 50060
Phone (641) 872-1050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 1510 | IA | Yes |
Addresses
Primary practice location
105 E Jackson St
Corydon, IA 50060-1408
Mailing address
PO Box 850442
Minneapolis, MN 55485-0442
Phone (515) 267-2800
Other names
- Hy-Vee Pharmacy (1089)
Other providers in Corydon, IA
- Marissa Kay Evers
- Noah Jacob Givant
- Patrick S Heffron
- Douglas W Hoch
- Shehada M Homedan
- Ojiaku Balewa Ikezuagu
- Samantha Imholte
- Infinity Health
- Brandon Lee Jenson
- Kylie Kent
All providers in Corydon, IA · Community/Retail Pharmacy in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.