Lees Marketplace Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

9903561-1703 Issued in UT

Legal business name

LEES MARKETPLACE INC

Doing business as

Lee's Marketplace-Heber City Pharmacy

Practice address

890 S Main St
Heber City, UT 84032-2463

Phone

(435) 654-0414

Fax

(435) 657-1972

NPI assigned

Jun 26, 2006

Last updated

Apr 19, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Badger

Title

President/Ceo

Phone

(435) 774-4150

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Lee's Marketplace-Heber City Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• Lees Marketplace Inc

  dba Lee's Marketplace Richmond Pharmacy

  • Community/Retail Pharmacy
  • Richmond, UT
  • NPI 1114630548

  O20170607000817

  Same enrollment
• Lees Marketplace Inc

  • Community/Retail Pharmacy
  • Logan, UT
  • NPI 1487702668

  O20170607000817

  Same enrollment
• Lees Marketplace Inc

  • Community/Retail Pharmacy
  • Smithfield, UT
  • NPI 1578671210

  O20170607000817

  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

Locations

Practitioners 3

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.

• Stacy Robinson Hall, RPH

  • Pharmacist
  • Heber City, UT
  • NPI 1760185433
  NPD (past)
• Cameron W Johnson, PHARMD

  • Pharmacist
  • Heber City, UT
  • NPI 1639064702
  NPD (past)
• Russell Ward, PHARM D

  • Pharmacist
  • Heber City, UT
  • NPI 1811619786
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1972530251",
    "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": "890 S MAIN ST",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840322463",
            "telephone_number": "435-654-0414",
            "fax_number": "435-657-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEES MARKETPLACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "BADGER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "435-774-4150"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "9903561-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2163879",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870575391001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lee's Marketplace-Heber City Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anthony Edward Kren, LCSW
• Thomas Herald Lamb, PHARMD
• David C. Larson, MD
• Peter S Leavitt, MD
• Brittny Lee, RN, BSN
• Dania Shane Lees, MD
• Legacy Anesthesia LLC
• Anthony Joseph Lepore, RN
• Zane Stillman Lewis
• Hannah Lima

• Community/Retail Pharmacy in Heber City, UT
• Providers in Heber City, 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 Apr 19, 2017; 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.