Provider Demographics
NPI:1669408050
Name:HY-VEE INC
Entity type:Organization
Organization Name:HY-VEE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASST. VICE PRESIDENT, PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:EGELAND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:515-453-2784
Mailing Address - Street 1:5820 WESTOWN PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8223
Mailing Address - Country:US
Mailing Address - Phone:515-453-2784
Mailing Address - Fax:515-327-2162
Practice Address - Street 1:10118 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1600
Practice Address - Country:US
Practice Address - Phone:913-491-6261
Practice Address - Fax:913-491-6293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS89083336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100433400AMedicaid
KS0213410178Medicare NSC