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MACEY'S INC #1058
NPI 1326371584
Pharmacy in Salt Lake City, UT

Active since September 04, 2009CLIA 46D1031890 · Waiver
4530 S HIGHLAND DR, SALT LAKE CITY, UT 84117(801) 278-5388(801) 278-1206 Get Directions Write a Review

NPPES record last updated: September 24, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 24, 2019, Sep 13, 2019, Oct 18, 2017 (3 updates tracked since 2017).

About Macey's Inc #1058 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MACEY'S INC #1058 (NPI 1326371584) is a healthcare organization registered as a pharmacy in Salt Lake City, Utah and active in the NPI registry since September 2009. The organization holds a CLIA Waiver certificate valid through December 20, 2026 and lists Shawna Kip Hanson, Director Of Pharmacy, as its authorized official.

NPPES Registry Identity

NPI1326371584
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameMACEYS INC
Location Address4530 S HIGHLAND DRSalt Lake City, UT 84117-4202
Mailing Address1850 W 2100 S, Attn Pharmacy DepartmentSalt Lake City, UT 84119-1304 · (801) 978-8225 · Fax (801) 978-8634
Phone(801) 278-5388
Fax(801) 278-1206
Organization SubpartNo
Authorized OfficialShawna Kip HansonDirector Of Pharmacy · (801) 978-8309
Enumeration DateSeptember 4, 2009
Last NPPES UpdateSeptember 24, 20193 updates tracked since enumeration
✔ NPI 1326371584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in UT · 7442364-1703
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
4530 S HIGHLAND DR, Salt Lake City, UT 84117
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Other Names 1

Other NameMacey's Inc #1058

Other Identifiers 2

Other2121816Pk
Medicaid1326371584UT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Macey's Inc #1058 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateUtahEnrollment IDO20080428000667Non-DME Part B · Mass Immunization (Roster Biller Only)Due dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D1031890

Macey's Pharmacy #1058 · Salt Lake City, UT
Active · expires Dec 20, 2026
CLIA Number46D1031890
Laboratory TypePharmacy
Certificate Effective DateDecember 21, 2024
Certificate Expiration DateDecember 20, 2026
Laboratory DirectorKevin Lawrence
Laboratory Phone(801) 278-5388
Laboratory LocationMacey's Pharmacy #10584530 S Highland Drive, Salt Lake City, UT 84111
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
131 services130 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
87 services87 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
39 services39 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
14 services14 patients
Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304
The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.
14 services14 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
14 services14 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maceys Inc's NPI number?

The NPI number for Maceys Inc is 1326371584. It was assigned to this organization in the NPPES registry on September 4, 2009. The provider is also known as Macey's Inc #1058.

Where is Maceys Inc located?

Maceys Inc is located at 4530 S Highland Dr, Salt Lake City, UT 84117. The listed phone number is (801) 278-5388.

What is Maceys Inc's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Is Maceys Inc enrolled in Medicare?

Yes. Maceys Inc is registered in the Medicare PECOS enrollment system.

When is Maceys Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Utah, Mass Immunization (Roster Biller Only)) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Maceys Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D1031890) is associated with this NPI, valid through December 20, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Maceys Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 48 other insurers list Maceys Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Maceys Inc was last updated on September 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.