Healthcare Provider Details

I. General information

NPI: 1720029960
Provider Name (Legal Business Name): IHC HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 02/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5252 SOUTH, INTERMOUNTAIN DRIVE
MURRAY UT
84107
US

IV. Provider business mailing address

4646 LAKE PARK BLVD
SALT LAKE CITY UT
84120-8212
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-2350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVE LARSEN
Title or Position: CFO
Credential:
Phone: 801-507-9523