NPIMap

Organization Active NPI

Lin'S Supermarkets Inc

  • Pharmacy
  • Richfield, UT
National Provider Identifier
1417280702
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
7442363-1703 Issued in UT
Legal business name
LIN'S SUPERMARKETS INC
Practice address
250 S Main St
Richfield, UT 84701-2559
Phone
(435) 896-5759
Fax
(435) 896-5844
NPI assigned
Sep 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 7442363-1703 UT Primary

Addresses

Primary practice location

250 S Main St
Richfield, UT 84701-2559

Mailing address

PO Box 26908
Salt Lake City, UT 84126-0908
Phone (801) 978-8225

Other identifiers 2

IdentifierTypeStateIssuer
1417280702MedicaidUT
2121824OtherPK

Other names 1

  • Lin's Supermarkets Inc #8 Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080403000257 UT Part B Supplier - Mass Immunization (Roster Biller Only) 2365529161 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Price, UT; St George, UT; Richfield, UT; Hurricane, UT; Cedar City, UT
O20101203000620 UT Part B Supplier - Mass Immunization (Roster Biller Only) 9335336312 30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salt Lake City, UT; South Ogden, UT; American Fork, UT; Park City, UT; Ogden, UT; Layton, UT; Provo, UT

Other NPIs on the same Medicare enrollment 22

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

View all 22

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
46D1032899Lin'S Supermarkets Inc #8250 S Main St, Richfield, UT 84701Certificate of waiverDec 20, 2026

National Provider Directory

National Provider Directory
Tax ID family
Associated Fresh Markets Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

150 N Main St
Cedar City, UT 84720
Phone (435) 865-6665

1120 W State St
Hurricane, UT 84737
Phone (435) 635-3840

760 W Price River Dr
Price, UT 84501
Phone (435) 637-7112

250 S Main St
Richfield, UT 84701
Phone (435) 896-5759

670 N Main St
Richfield, UT 84701
Phone (435) 896-9253

1930 W Sunset Blvd
St George, UT 84770
Phone (435) 673-9781

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569283200000",
    "number": "1417280702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26908",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841260908",
            "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": "250 S MAIN ST",
            "city": "RICHFIELD",
            "state": "UT",
            "postal_code": "847012559",
            "telephone_number": "435-896-5759",
            "fax_number": "435-896-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIN'S SUPERMARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-17",
        "last_updated": "2019-09-24",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_middle_name": "KIP",
        "authorized_official_title_or_position": "DIRECTOR, PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "801-978-8309"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "UT",
            "license": "7442363-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417280702",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121824",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lin's Supermarkets Inc #8",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lin's Supermarkets Inc #8",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Richfield, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.