Organization
MACEY'S INC
Active
Other names
Macey's Pharmacy #1064
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA KIP HANSON (DIRECTOR OF PHARMACY)
(801) 978-8309
Entity
Organization
Contact information
Practice address
1212 E DRAPER PKWY, DRAPER, UT 84020-9097
(801) 571-1406
(801) 571-1085
Mailing address
1850 W 2100 S, SALT LAKE CITY, UT 84119-1304
(801) 978-8699
(801) 978-8634
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386963593
—
UT
01
—
2125301
PK
—
Enumeration date
05/27/2010
Last updated
01/16/2019
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