MEDICARE: IHC HEALTH SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558436980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IHC HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	11520 S REDWOOD RD
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84095-7805
Country	:	US
Telephone Number	:	385-887-6000
Fax Number	:	801-442-0603

Provider Business Practice Location Address
First Line	:	550 E 1400 N STE G
Second Line	:
City	:	LOGAN
State	:	UT
Zip	:	84341-2450
Country	:	US
Telephone Number	:	435-716-5477
Fax Number	:

Authorized Official
Title or Position	:	VP-HOMECARE HOSPICE PALLIATIVE CARE
Name	:	MARK PROVAN
Credential	:
Telephone Number	:	801-442-2000

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	01/29/2025

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Directions to “IHC HEALTH SERVICES INC ” Practice Location

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