Provider Demographics
NPI:1780270652
Name:HY-VEE HEALTH EXEMPLAR CARE
Entity type:Organization
Organization Name:HY-VEE HEALTH EXEMPLAR CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:VAN DER VEER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:319-530-3786
Mailing Address - Street 1:7300 WESTOWN PKWY STE 330
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-2527
Mailing Address - Country:US
Mailing Address - Phone:515-650-4370
Mailing Address - Fax:515-650-4373
Practice Address - Street 1:7300 WESTOWN PKWY STE 330
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-2527
Practice Address - Country:US
Practice Address - Phone:515-650-4370
Practice Address - Fax:833-907-2284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA7107077Medicaid