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	207P00000X	Emergency Medicine Physician	1154	UT

General Provider Information

NPI Number	:	1255465142
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	:	801-620-1040
Fax Number	:

Provider Business Practice Location Address
First Line	:	3925 SNOWBASIN RD
Second Line	:
City	:	HUNTSVILLE
State	:	UT
Zip	:	84317
Country	:	US
Telephone Number	:	801-620-1040
Fax Number	:

Authorized Official
Title or Position	:	CEO INTERMOUNTAIN MEDICAL GROUP
Name	:	DR. LINDA C LECKMAN
Credential	:	MD
Telephone Number	:	801-442-3974

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/30/2008

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Directions to “IHC HEALTH SERVICES INC. ” Practice Location

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