MEDICARE: IHC HEALTH SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1063646917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IHC HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:	801-507-3533
Fax Number	:

Provider Business Practice Location Address
First Line	:	2720 HOMESTEAD RD
Second Line	:	STE 100
City	:	PARK CITY
State	:	UT
Zip	:	84098-4881
Country	:	US
Telephone Number	:	801-507-3500
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KELLY J HOWARD
Credential	:
Telephone Number	:	801-442-1425

Provider Enumeration Date	:	05/06/2009
Last Update Date	:	05/06/2009

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Directions to “IHC HEALTH SERVICES INC ” Practice Location

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