Active NPI
Hy-Vee Inc
Doing business as Hy-Vee Pharmacy (1297)
- Community/Retail Pharmacy
- Jefferson, IA
National Provider Identifier
1972548303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 822
- Legal business name
- HY-VEE INC
- Doing business as
- Hy-Vee Pharmacy (1297)
- Practice address
- 106 W. Washington Street
Suite 1
Jefferson, IA 50129 - Phone
- (515) 386-4152
- Fax
- (515) 386-3526
- NPI assigned
- Jun 19, 2006
- Last updated
- Sep 13, 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 |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 822 | IA | Primary |
| Long Term Care Pharmacy | 3336L0003X | 822 | IA |
Addresses
Primary practice location
106 W. Washington Street
Suite 1
Jefferson, IA 50129
Mailing address
PO Box 850442
Minneapolis, MN 55485-0442
Phone (515) 267-2800
Other names 1
- Hy-Vee Pharmacy (1297)
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 2
| 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 |
| O20100930025227 | IA | DME Supplier - Pharmacy | 7416855242 | Practice locations: Jefferson, IA |
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 |
|---|---|---|---|
| 16D2096749 | Hy-Vee Pharmacy #1297 | Certificate of waiver | Jul 31, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Hy-Vee Pharmacy (1297) | 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 |
National Provider Directory
National Provider Directory- Tax ID family
- Hyvee Inc
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.
-
- Skilled Nursing Facility
- Urbandale, IA
- NPI 1922175611
-
dba Hy-Vee Pharmacy #1 (1092)
- Community/Retail Pharmacy
- Council Bluffs, IA
- NPI 1942239454
-
dba Hy-Vee Pharmacy Fulfillment Center (4016)
- Community/Retail Pharmacy
- Des Moines, IA
- NPI 1972125367
Locations
106 W Washington St
Ste 1
Jefferson, IA 50129
Phone (515) 386-4151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694563200000",
"number": "1972548303",
"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": "106 W. WASHINGTON STREET",
"address_2": "SUITE 1",
"city": "JEFFERSON",
"state": "IA",
"postal_code": "50129",
"telephone_number": "515-386-4152",
"fax_number": "515-386-3526"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HY-VEE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-19",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"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": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IA",
"license": "822",
"primary": true
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "IA",
"license": "822",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Hy-Vee Pharmacy (1297)",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Hy-Vee Pharmacy (1297)",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Jefferson, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.