Provider Demographics
NPI:1053958348
Name:HY-VEE INC
Entity type:Organization
Organization Name:HY-VEE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT, PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-267-7703
Mailing Address - Street 1:PO BOX 310442
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50331-0442
Mailing Address - Country:US
Mailing Address - Phone:515-267-2800
Mailing Address - Fax:515-559-2593
Practice Address - Street 1:4707 FLEUR DR
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50321-2335
Practice Address - Country:US
Practice Address - Phone:515-953-7413
Practice Address - Fax:515-953-7415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy