NPIMap

Organization Active NPI

Associated Fresh Markets Inc

  • Community/Retail Pharmacy
  • South Ogden, UT
National Provider Identifier
1982938239
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
7442355-1703 Issued in UT
Legal business name
ASSOCIATED FRESH MARKETS INC
Practice address
5691 Harrison Blvd
South Ogden, UT 84403-4322
Phone
(801) 479-0827
Fax
(801) 476-4262
NPI assigned
Sep 18, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Shawna Hanson, PHARMD
Title
Director, Pharmacy Operations
Phone
(801) 978-8309

Other NPIs on the same Medicare enrollment 18

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

View all 18

Corporate family (same tax ID) 9

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

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
46D1031994Fresh Market Pharmacy #23885691 S Harrison Blvd, South Ogden, UT 84403Certificate of waiverDec 21, 2026

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

National Provider Directory
Tax ID family
Associated Fresh Markets Inc (10 organizations share this tax ID)

Locations

5691 Harrison Blvd
South Ogden, UT 84403
Phone (801) 479-0827

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 7442355-1703 UT Primary

Addresses

NPPES NPI Registry

Primary practice location

5691 Harrison Blvd
South Ogden, UT 84403-4322

Mailing address

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

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
2121994OtherPK
1982938239MedicaidUT

Other names 1

NPPES NPI Registry
  • Fresh Market Pharmacy #2388 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 24, 2019.

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569283200000",
    "number": "1982938239",
    "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": "5691 HARRISON BLVD",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034322",
            "telephone_number": "801-479-0827",
            "fax_number": "801-476-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED FRESH MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-18",
        "last_updated": "2019-09-24",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "DIRECTOR, PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "801-978-8309",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "7442355-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121994",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982938239",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresh Market Pharmacy #2388",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fresh Market Pharmacy #2388",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Ogden, 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.