Hy-Vee Inc
Organization Active NPI Community/Retail Pharmacy · Johnston, IA
NPI 1790711463 · NPPES record last updated Sep 22, 2023
Key facts
- NPI
- 1790711463
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 1132 (IA)
- Legal business name
- HY-VEE INC
- Practice address
- 5750 Merle Hay Rd
Johnston, IA 50131-1215 - Phone
- (515) 270-9212
- Fax
- (515) 270-0860
- NPI assigned
- Jun 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Angie Nelson
- Title
- Senior Vice President
- Phone
- (515) 267-2800
Corporate family (same tax ID) 24
Practitioners 2
-
Stephanie Main, RPH
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D1003298 | Hy-Vee Pharmacy #1318 | Certificate of waiver | Aug 26, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Hy-Vee Pharmacy (1318) |
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 |
| O20100930050640 | IA | DME Supplier - Pharmacy |
7416855242 | Practice locations: Johnston, IA |
National Provider Directory
- Tax ID family
- Drug Town 7060
Locations
5820 Westown Pkwy
West Des Moines, IA 50266
Phone (515) 453-2784
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 1132 | IA | |
| Community/Retail Pharmacy | 3336C0003X | 1132 | IA | Yes |
Addresses
Primary practice location
5750 Merle Hay Rd
Johnston, IA 50131-1215
Mailing address
PO Box 850442
Minneapolis, MN 55485-0442
Phone (515) 267-2800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0213769 | Medicaid | IA | |
| 1620675 | Other | IA | NCPDP |
Other names
- Hy-Vee Pharmacy
Other providers in Johnston, IA
- Sydney Charlize Hughes
- Leah Hughett
- Nathan M. Hull
- Sarah Elizabeth Hulstein
- Lindsey Marie Hundson
- Impact Health Institute LLC
- Implied Human Dynamics Personal Care Home
- Indira Inabathini
- Independence Care of Iowa LLC
- Madison Inglis
All providers in Johnston, 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 Sep 22, 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.