# IHC HEALTH SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** IHC HEALTH SERVICES INC
- **Other names:** PRIMARY CHILDRENS OUTPATIENT PHARMACY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790892404
- **Legal business name:** IHC HEALTH SERVICES INC
- **Authorized official:** NANNETTE BERENSEN (VICE PRESIDENT OF CLINICAL SYSTEMS)
- **Authorized official phone:** (801) 507-8002

## Contact information

- **Practice address:** 100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
- **Practice address phone:** (801) 662-1680
- **Practice address fax:** (801) 662-1688
- **Mailing address:** PO BOX 30013, SALT LAKE CITY, UT 84130-0013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 49062421703 | UT | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 02/21/2024