Healthcare Provider Details
I. General information
NPI: 1700901790
Provider Name (Legal Business Name): IHC HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2007
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1380 E MEDICAL CENTER DR
ST GEORGE UT
84790-2123
US
IV. Provider business mailing address
PO BOX 27128
SALT LAKE CITY UT
84127-0128
US
V. Phone/Fax
- Phone: 801-442-1400
- Fax:
- Phone: 801-442-1400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
KELLY
J
HOWARD
Title or Position: DIRECTOR
Credential:
Phone: 801-442-1425