Healthcare Provider Details

I. General information

NPI: 1588604086
Provider Name (Legal Business Name): IHC HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 S HIGHWAY 40
HEBER UT
84032-3522
US

IV. Provider business mailing address

PO BOX 30180
SALT LAKE CITY UT
84130-0180
US

V. Phone/Fax

Practice location:
  • Phone: 435-654-2500
  • Fax: 435-654-2576
Mailing address:
  • Phone: 801-357-7475
  • Fax: 801-357-7997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number2006HOSP213
License Number StateUT

VIII. Authorized Official

Name: MR. CRAIG WILEY
Title or Position: PAS MGR
Credential:
Phone: 801-357-7027