Healthcare Provider Details
I. General information
NPI: 1043324585
Provider Name (Legal Business Name): IHC HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2006
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1501 HILAND AVE
BURLEY ID
83318-2682
US
IV. Provider business mailing address
PO BOX 30180
SALT LAKE CITY UT
84130-0180
US
V. Phone/Fax
- Phone: 208-677-6215
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 176B00000X |
| Taxonomy | Midwife |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DENIS
SMITH
Title or Position: ADMINISTRATOR
Credential:
Phone: 801-442-2000