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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
1207Q00000XFamily Medicine Physician55963UT

General Provider Information

NPI Number : 1992830103
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 : 801-571-0030
Fax Number :
Provider Business Practice Location Address
First Line : 955 E 11400 S
Second Line :
City : SANDY
State : UT
Zip : 84094-6946
Country : US
Telephone Number : 801-571-0030
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 : 02/21/2007
Last Update Date : 07/30/2008

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Directions to “IHC HEALTH SERVICES INC ” Practice Location

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