NPIMap

Organization Active NPI

Maceys Inc

  • Community/Retail Pharmacy
  • SLC, UT
National Provider Identifier
1083723142
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MACEYS INC
Practice address
3981 Wasatch Blvd
SLC, UT 84124-2247
Phone
(801) 272-9494
Fax
(801) 272-2687
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shawna Kip Hanson
Title
Director of Pharmacy
Phone
(801) 978-8309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

3981 Wasatch Blvd
SLC, UT 84124-2247

Mailing address

PO Box 26417
SLC, UT 84126-0417
Phone (801) 978-8225

Other names 1

  • Macey's Pharmacy #0962 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080428000667 UT Part B Supplier - Mass Immunization (Roster Biller Only) 2466530688 16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Provo, UT; West Valley City, UT; West Jordan, UT; Tooele, UT; Taylorsville, UT; Spanish Fork, UT; Sandy, UT; Salt Lake City, UT…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D1035978Macey'S Inc #09623981 Wasatch Boulevard, Salt Lake City, UT 84124Certificate of waiverJan 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Maceys Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1850 W 2100 S
Salt Lake City, UT 84119
Phone (801) 978-8312

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1083723142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26417",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841260417",
            "telephone_number": "801-978-8225",
            "fax_number": "801-978-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3981 WASATCH BLVD",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841242247",
            "telephone_number": "801-272-9494",
            "fax_number": "801-272-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACEYS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_middle_name": "KIP",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "801-978-8309"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Macey's Pharmacy #0962",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in SLC, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.