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Organization

IHC HEALTH SERVICES, INC.

Active
Other names
Tooele Valley Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
DAVE LARSEN (CHIEF FINANCIAL OFFICER)
(801) 408-1883
Entity
Organization

Contact information

Practice address
196 WEST 2000 NORTH, SUITE 112, TOOELE, UT 84074-2736
(801) 408-1430
Mailing address
4646 LAKE PARK BLVD, SALT LAKE CITY, UT 84120-8212

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
2005-ESRD-0608
UT

Other

Enumeration date
01/24/2007
Last updated
02/25/2016
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