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MACEY'S INC. #1068
NPI 1700119013
Pharmacy - Community/Retail Pharmacy in West Valley City, UT

Active since September 18, 2009CLIA 46D1031915 · Waiver
3555 W 3500 S, WEST VALLEY CITY, UT 84119(801) 963-6874(801) 965-9953 Get Directions Write a Review

NPPES record last updated: June 11, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 11, 2021, Sep 24, 2019, Oct 2, 2015 (3 updates tracked since 2015).

About Macey's Inc. #1068 NPPES

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

MACEY'S INC. #1068 (NPI 1700119013) is a healthcare organization registered as a community/retail pharmacy in West Valley City, Utah and active in the NPI registry since September 2009. The organization holds a CLIA Waiver certificate valid through December 21, 2026 and lists Shawna Kip Hanson, Director Of Pharmacy, as its authorized official.

NPPES Registry Identity

NPI1700119013
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameMACEYS INC
Location Address3555 W 3500 SWest Valley City, UT 84119-2539
Mailing AddressPo Box 26908Salt Lake City, UT 84126-0908 · (801) 978-8225 · Fax (801) 978-8634
Phone(801) 963-6874
Fax(801) 965-9953
Organization SubpartNo
Authorized OfficialShawna Kip HansonDirector Of Pharmacy · (801) 978-8309
Enumeration DateSeptember 18, 2009
Last NPPES UpdateJune 11, 20213 updates tracked since enumeration
NPPES CertifiedJune 11, 2021
✔ NPI 1700119013 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
3555 W 3500 S, West Valley City, UT 84119
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Other Names 1

Other NameMacey's Inc. #1068

Other Identifiers 2

Other2121986Pk
Medicaid1700119013UT

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. #1068 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 46D1031915

Macey's #1068 · West Valley City, UT
Active · expires Dec 21, 2026
CLIA Number46D1031915
Laboratory TypePharmacy
Certificate Effective DateDecember 22, 2024
Certificate Expiration DateDecember 21, 2026
Laboratory DirectorAlandria M. Smitch
Laboratory Phone(801) 963-6874
Laboratory LocationMacey's #10683555 W 3500 S, West Valley City, UT 84119
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

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.
22 services22 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.
12 services12 patients

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALANDRIA JENSEN PHARMD
Pharmacist
3555 W 3500 S
WEST VALLEY CITY, UT 84119
Salt Lake County (801) 963-6874
MR. KYLE D HANSEN PHARMD
Pharmacist
3555 W 3500 S
WEST VALLEY CITY, UT 84119
Salt Lake County (801) 963-6874
LISA ANN BULLOUGH RPH
Pharmacist
3555 W 3500 S
WEST VALLEY CITY, UT 84119
Salt Lake County (801) 963-6874

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 1700119013. It was assigned to this organization in the NPPES registry on September 18, 2009. The provider is also known as Macey's Inc. #1068.

Where is Maceys Inc located?

Maceys Inc is located at 3555 W 3500 S, West Valley City, UT 84119. The listed phone number is (801) 963-6874.

What is Maceys Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

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 46D1031915) is associated with this NPI, valid through December 21, 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 June 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.