# MACEYS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Macey's Pharmacy \#3
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083723217
- **Authorized official:** SHAWNA K HANSON (DIRECTOR OF PHARMACY OPERATIONS)
- **Authorized official phone:** (801) 978-8309

## Contact information

- **Practice address:** 1402 N STATE ST, PROVO, UT 84604-2415
- **Practice address phone:** (801) 377-0307
- **Practice address fax:** (801) 377-3242
- **Mailing address:** PO BOX 26417, SALT LAKE CITY, UT 84126-0417
- **Mailing address phone:** (801) 978-8225
- **Mailing address fax:** (801) 978-8634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 379792-1703 | UT | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 09/24/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 870475597022 | — | UT |