Provider Demographics
NPI:1700115086
Name:HYVACS, LLC
Entity Type:Organization
Organization Name:HYVACS, LLC
Other - Org Name:HY-VEE PHARMACY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RINGENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-267-7784
Mailing Address - Street 1:10004 S 152ND ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-3930
Mailing Address - Country:US
Mailing Address - Phone:402-861-4938
Mailing Address - Fax:402-861-4941
Practice Address - Street 1:10004 S 152ND ST
Practice Address - Street 2:SUITE C
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68138-3930
Practice Address - Country:US
Practice Address - Phone:402-861-4938
Practice Address - Fax:402-861-4941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X, 332B00000X, 332BP3500X, 3336C0004X, 3336H0001X, 3336S0011X
NE4003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025828200Medicaid
NE6388480001Medicare NSC