Organization
HY-VEE INC
Active
Other names
Hy-Vee Pharmacy #2 (1261)
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE NELSON (SENIOR VICE PRESIDENT)
(515) 267-2800
Entity
Organization
Contact information
Practice address
4545 S NOLAND RD, INDEPENDENCE, MO 64055-4744
(816) 478-1968
(816) 478-5649
Mailing address
PO BOX 850442, MINNEAPOLIS, MN 55485-0042
(515) 267-2800
(515) 559-2593
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2004010800
MO
3336C0003X
Community/Retail Pharmacy
Primary
200401800
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2635437
NCPDP
MO
05
—
606130201
—
MO
Enumeration date
07/11/2006
Last updated
04/25/2023
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