Provider Demographics
NPI:1952748519
Name:MACEYS INC
Entity Type:Organization
Organization Name:MACEYS INC
Other - Org Name:MACEYS PHARMACY #13
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:801-978-8309
Mailing Address - Street 1:PO BOX 26417
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84126-0417
Mailing Address - Country:US
Mailing Address - Phone:801-978-8825
Mailing Address - Fax:801-978-8634
Practice Address - Street 1:325 36TH ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-1673
Practice Address - Country:US
Practice Address - Phone:801-399-5866
Practice Address - Fax:801-621-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy