Active NPI
Hy-Vee Inc
Doing business as Hy-Vee Pharmacy (1076)
- Community/Retail Pharmacy
- Columbia, MO
National Provider Identifier
1871520221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 2001019081
- Legal business name
- HY-VEE INC
- Doing business as
- Hy-Vee Pharmacy (1076)
- Practice address
- 3100 W Broadway
Columbia, MO 65203-0102 - Phone
- (573) 447-2144
- Fax
- (573) 445-8227
- NPI assigned
- Jun 28, 2006
- Last updated
- Sep 15, 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
- Angie Nelson
- Title
- Senior Vice President
- Phone
- (515) 267-2800
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 2001019081 | MO | |
| Community/Retail Pharmacy | 3336C0003X | 2001019081 | MO | Primary |
Addresses
Primary practice location
3100 W Broadway
Columbia, MO 65203-0102
Mailing address
PO Box 850442
Minneapolis, MN 55485-0442
Phone (515) 267-2800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2633964 | Other | MO | NCPDP |
| 605456102 | Medicaid | MO | |
| 625456108 | Medicaid | MO |
Other names 1
- Hy-Vee Pharmacy (1076)
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070213000432 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 7416855242 |
6 other NPIs on this enrollment Practice locations: Columbia, MO; Jefferson City, MO; Kirksville, MO; Springfield, MO |
| O20100930063179 | MO | DME Supplier - Pharmacy | 7416855242 | Practice locations: Columbia, MO |
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Hy-Vee Pharmacy (1082)
- Community/Retail Pharmacy
- Columbia, MO
- NPI 1063735272
O20070213000432
-
dba Hy-Vee Pharmacy (1335)
- Community/Retail Pharmacy
- Kirksville, MO
- NPI 1467482281
O20070213000432
-
dba Hy-Vee Pharmacy (1641)
- Community/Retail Pharmacy
- Springfield, MO
- NPI 1578843231
O20070213000432
-
dba Hy-Vee Pharmacy (1303)
- Community/Retail Pharmacy
- Jefferson City, MO
- NPI 1699968750
O20070213000432
-
dba Hy-Vee Pharmacy #2 (1081)
- Community/Retail Pharmacy
- Columbia, MO
- NPI 1801029830
O20070213000432
-
dba Hy-Vee Pharmacy 2 (1644)
- Community/Retail Pharmacy
- Springfield, MO
- NPI 1912650300
O20070213000432
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D1028575 | Hy-Vee Pharmacy 1076 | Certificate of waiver | Jul 26, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Hy-Vee Pharmacy #1 (1076) | 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 assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Hy-Vee Pharmacy 1522
Organizations with this tax ID in the same state 18
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694736000000",
"number": "1871520221",
"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": "3100 W BROADWAY",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652030102",
"telephone_number": "573-447-2144",
"fax_number": "573-445-8227"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HY-VEE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-28",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"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": "MO",
"license": "2001019081",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MO",
"license": "2001019081",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "2633964",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "605456102",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "625456108",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hy-Vee Pharmacy (1076)",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Hy-Vee Pharmacy (1076)",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.