Provider Demographics
NPI:1316356827
Name:HY-VEE INC
Entity Type:Organization
Organization Name:HY-VEE INC
Other - Org Name:GORDON DRIVE HY-VEE DIABETES EDUCATION PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
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:712-225-1903
Mailing Address - Fax:515-559-2593
Practice Address - Street 1:3301 GORDON DR
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51105-3708
Practice Address - Country:US
Practice Address - Phone:712-234-1949
Practice Address - Fax:712-255-8087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy