NPIMap

Organization Active NPI

Hy-Vee Inc

Doing business as Hy-Vee Pharmacy (1544)

  • Community/Retail Pharmacy
  • Red Oak, IA
National Provider Identifier
1952337347
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
755 Issued in IA
Legal business name
HY-VEE INC
Doing business as
Hy-Vee Pharmacy (1544)
Practice address
1605 N Broadway St
Red Oak, IA 51566-1027
Phone
(712) 623-3370
Fax
(712) 623-2839
NPI assigned
Jun 25, 2006
Last updated
Feb 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 755 IA
Community/Retail Pharmacy 3336C0003X 755 IA Primary
Long Term Care Pharmacy 3336L0003X 755 IA

Addresses

Primary practice location

1605 N Broadway St
Red Oak, IA 51566-1027

Mailing address

PO Box 850442
Minneapolis, MN 55485-0442
Phone (515) 267-2800

Other identifiers 2

IdentifierTypeStateIssuer
1620827OtherIANCPDP
0224188MedicaidIA

Other names 1

  • Hy-Vee Pharmacy (1544) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031230000598 IA Part B Supplier - Mass Immunization (Roster Biller Only) 7416855242 This NPI is an additional NPI on the enrollment
Practice locations: Albia, IA
O20100930025281 IA DME Supplier - PharmacyDME Supplier - Grocery Store 7416855242 Practice locations: Red Oak, IA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1023108Hy-Vee Pharmacy #15441605 Broadway Box 45, Red Oak, IA 51566Certificate of waiverMar 7, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hy Vee Pharmacy 15441605 N Broadway St, Red Oak, IA 51566-1027(712) 623-3370 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 assignmentParticipating since Dec 7, 2017

National Provider Directory

National Provider Directory
Tax ID family
Hy-Vee Pharmacy 1522278 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

1605 N Broadway St
Red Oak, IA 51566
Phone (712) 623-3370

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1675900800000",
    "number": "1952337347",
    "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": "1605 N BROADWAY ST",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515661027",
            "telephone_number": "712-623-3370",
            "fax_number": "712-623-2839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HY-VEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "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": "IA",
            "license": "755",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "755",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IA",
            "license": "755",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1620827",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0224188",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hy-Vee Pharmacy (1544)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hy-Vee Pharmacy (1544)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Red Oak, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.

Verify at the official NPI Registry.