Organization
IHC HEALTH SERVICES INC
Active
Parent organization
IHC HEALTH SERVICES INC
Other names
LOGAN CLINIC PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
IHC HEALTH SERVICES INC
Authorized official
NANNETTE BERENSEN (VICE PRESIDENT OF CLINICAL SYSTEMS)
(801) 284-1005
Entity
Organization
Contact information
Practice address
412 N 200 E, LOGAN, UT 84321-4038
(435) 713-2770
(435) 713-2787
Mailing address
PO BOX 30013, SALT LAKE CITY, UT 84130-0013
(435) 713-2770
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
70157141703
UT
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053575175
—
ID
05
—
1053575175
—
UT
01
—
2100988
PK
—
Enumeration date
07/17/2008
Last updated
07/19/2018
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