Badger Management LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BADGER MANAGEMENT LLC

Doing business as

Lee's Marketplace- Mt. Green
Lee's Marketplace-Mt. Green

Practice address

4935 Old Highway Rd
Mountain Green, UT 84050

Phone

(435) 774-4150

Fax

(435) 774-4166

NPI assigned

May 3, 2024

Last updated

May 3, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

BADGER MANAGEMENT LLCAs reported in NPPES

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

Authorized official

Name

Crystal Grimes, RPH

Title

Director of Pharmacy

Phone

(435) 774-4150

Specialties & licenses 1

Addresses

Other names 2

• Lee's Marketplace- Mt. Green Doing business as
• Lee's Marketplace-Mt. Green Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Badger Management LLC

  dba Lee's MarketPlace - Foxboro Pharmacy

  • Community/Retail Pharmacy
  • N Salt Lake, UT
  • NPI 1083157382

  5092098319

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Badger Management LLC

  dba Lee's MarketPlace - Foxboro Pharmacy

  • Community/Retail Pharmacy
  • N Salt Lake, UT
  • NPI 1083157382

  O20241001003935

  Same enrollment

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

CLIA laboratory certificates

Tax ID family

Badger Management LLC4 organizations share this tax ID, including this one

Part of

Badger Management LLC

Other organizations with this tax ID 3

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

• Badger Management LLC

  dba Lee's MarketPlace - Foxboro Pharmacy

  • Community/Retail Pharmacy
  • N Salt Lake, UT
  • NPI 1083157382
  NPD tax ID
• Badger Management LLC

  dba Bella's Market Pharmacy

  • Pharmacy
  • Vineyard, UT
  • NPI 1306718135
  NPD tax ID
• Badger Management LLC

  dba Bella's Market Pharmacy

  • Community/Retail Pharmacy
  • Vineyard, UT
  • NPI 1356215008
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christine Cheng

  • Pharmacist
  • North Salt Lake, UT
  • NPI 1619737046
  NPD (past)
• Emily Erickson, RPH

  • Pharmacist
  • North Salt Lake, UT
  • NPI 1760103246
  NPD (past)

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1336996602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E 1400 N STE 110",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412459",
            "telephone_number": "435-774-4150",
            "fax_number": "435-774-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4935 OLD HIGHWAY RD",
            "city": "MOUNTAIN GREEN",
            "state": "UT",
            "postal_code": "84050",
            "telephone_number": "435-774-4150",
            "fax_number": "435-774-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BADGER MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BADGER MANAGEMENT  LLC",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "435-774-4150",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lee's Marketplace- Mt. Green",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lee's Marketplace-Mt. Green",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Mountain Green, UT
• Providers in Mountain Green, UT by specialty
• Community/Retail Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.