Healthcare Provider Details
I. General information
NPI: 1386741304
Provider Name (Legal Business Name): IHC HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2006
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
289 W 1230 N
PROVO UT
84604-2546
US
IV. Provider business mailing address
11520 S REDWOOD RD
SOUTH JORDAN UT
84095-7805
US
V. Phone/Fax
- Phone: 801-224-3382
- Fax:
- Phone: 385-887-6000
- Fax: 801-442-0603
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARK
PROVAN
Title or Position: VP-HOMECARE HOSPICE PALLIATIVE CARE
Credential:
Phone: 801-442-2000