Active NPI
Hy-Vee Inc
- Community/Retail Pharmacy
- Storm Lake, IA
National Provider Identifier
1891975033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- HY-VEE INC
- Doing business as
- Hy-Vee Clinic Pharmacy (1634)
- Practice address
- 606 Lake Ave
Storm Lake, IA 50588-1852 - Phone
- (712) 732-5067
- Fax
- (712) 732-4039
- NPI assigned
- Nov 5, 2007
- 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
- Robert G. Egeland
- Title
- VP, Pharmacy
- Phone
- (515) 453-2784
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 616 | IA | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
606 Lake Ave
Storm Lake, IA 50588-1852
Mailing address
PO Box 61
Cherokee, IA 51012-0061
Phone (712) 225-1903
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891975033 | Medicaid | IA | |
| 16-23239 | Other | IA | NCPDP |
Other names 1
- Hy-Vee Clinic Pharmacy (1634)
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| 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 |
National Provider Directory
National Provider DirectoryLocations
606 Lake Ave
Storm Lake, IA 50588
Phone (712) 732-5067
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194220800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696377600000",
"number": "1891975033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 61",
"city": "CHEROKEE",
"state": "IA",
"postal_code": "510120061",
"telephone_number": "712-225-1903",
"fax_number": "712-225-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 LAKE AVE",
"city": "STORM LAKE",
"state": "IA",
"postal_code": "505881852",
"telephone_number": "712-732-5067",
"fax_number": "712-732-4039"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HY-VEE INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-11-05",
"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": "VP, PHARMACY",
"authorized_official_telephone_number": "515-453-2784"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "IA",
"license": "616",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891975033",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "16-23239",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hy-Vee Clinic Pharmacy (1634)",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Hy-Vee Clinic Pharmacy (1634)",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Storm Lake, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.