Provider Demographics
NPI:1316277874
Name:HY-VEE INC
Entity type:Organization
Organization Name:HY-VEE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:V. PRESIDENT, PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:EGELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-453-2784
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:IA
Mailing Address - Zip Code:51012-0061
Mailing Address - Country:US
Mailing Address - Phone:712-225-5706
Mailing Address - Fax:712-225-5700
Practice Address - Street 1:3505 L ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-2565
Practice Address - Country:US
Practice Address - Phone:402-731-9971
Practice Address - Fax:402-731-8367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20043336L0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025830700Medicaid