Healthcare Provider Details

I. General information

NPI: 1144270919
Provider Name (Legal Business Name): IHC HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 N 500 W
PROVO UT
84604-3380
US

IV. Provider business mailing address

PO BOX 30180
SALT LAKE CITY UT
84130-0180
US

V. Phone/Fax

Practice location:
  • Phone: 801-357-7475
  • Fax: 801-357-7997
Mailing address:
  • Phone: 801-357-7475
  • Fax: 801-357-7997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number2006-HOSP-210
License Number StateUT

VIII. Authorized Official

Name: MR. CRAIG WILEY
Title or Position: PAS MGR
Credential:
Phone: 80013577027