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NPI Code Detail

MEDICARE: IHC HEALTH SERVICES, INC

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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1265674246
Entity Type Code : Organization
Provider Name (Legal Business Name) : IHC HEALTH SERVICES, INC
Provider Business Mailing Address
First Line : 4646 LAKE PARK BLVD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84120-8212
Country : US
Telephone Number : 801-442-8468
Fax Number : 801-442-0066
Provider Business Practice Location Address
First Line : 4646 LAKE PARK BLVD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84120-8212
Country : US
Telephone Number : 801-442-1466
Fax Number : 801-442-0066
Authorized Official
Title or Position : MEDICARE ENROLLMENT SPECIALIST
Name : MRS. HEATHER PAYNE
Credential :
Telephone Number : 801-442-8468
Provider Enumeration Date : 04/06/2009
Last Update Date : 04/14/2011

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Directions to “IHC HEALTH SERVICES, INC ” Practice Location

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