Healthcare Provider Details

I. General information

NPI: 1528183597
Provider Name (Legal Business Name): IHC HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 BONANZA DR
PARK CITY UT
84060-5127
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-442-1400
  • Fax:
Mailing address:
  • Phone: 801-442-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CRAIG THORNOCK
Title or Position: COO - A/R MANAGEMENT
Credential:
Phone: 801-442-1338