Organization
HY-VEE INC
Active
Other names
Hy-Vee Clinic Pharmacy (1036)
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE NELSON (SENIOR VICE PRESIDENT)
(515) 267-2800
Entity
Organization
Contact information
Practice address
710 MAIN ST, PRINCETON, MO 64673
(660) 748-7730
(660) 748-7733
Mailing address
PO BOX 850442, MINNEAPOLIS, MN 55485-0442
(515) 267-2800
(515) 559-2593
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2002000054
MO
3336C0003X
Community/Retail Pharmacy
Primary
2002000054
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0550921
—
IA
01
—
2634346
NCPDP
MO
05
—
608585006
—
MO
05
—
62885002
—
MO
Enumeration date
06/23/2006
Last updated
09/22/2023
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