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	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336C0003X	Community/Retail Pharmacy	10594981-1703	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2108195	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326155037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IHC HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 30013
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84130-0013
Country	:	US
Telephone Number	:	801-357-7333
Fax Number	:

Provider Business Practice Location Address
First Line	:	395 W 1230 N STE 204
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-3328
Country	:	US
Telephone Number	:	801-357-7333
Fax Number	:	801-357-7437

Authorized Official
Title or Position	:	VICE PRESIDENT OF CLINICAL SYSTEMS
Name	:	NANNETTE BERENSEN
Credential	:
Telephone Number	:	801-284-1005

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	09/19/2025

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Directions to “IHC HEALTH SERVICES, INC. ” Practice Location

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