Healthcare Provider Details

I. General information

NPI: 1649400573
Provider Name (Legal Business Name): IHC HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 E MYRTLE AVE STE 103
MURRAY UT
84107-4850
US

IV. Provider business mailing address

11520 S REDWOOD RD
SOUTH JORDAN UT
84095-7805
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-9100
  • Fax:
Mailing address:
  • Phone: 385-887-6000
  • Fax: 801-442-0603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateUT

VIII. Authorized Official

Name: MARK PROVAN
Title or Position: VP-HOMECARE HOSPICE PALLIATIVE CARE
Credential:
Phone: 801-442-2000