Organization
IHC HEALTH SERVICES INC
Active
Parent organization
IHC HEALTH SERVICES INC
Other names
Intermountain Health Infusion Pharmacy Salt Lake, Intermountain Health Infusion Pharmacy St. George
Organization subpart
Yes
Provider details
NPI number
Legal business name
IHC HEALTH SERVICES INC
Authorized official
MARK PROVAN (VP-HOMECARE HOSPICE PALLIATIVE CARE)
(801) 442-2000
Entity
Organization
Contact information
Practice address
11520 S REDWOOD RD, SOUTH JORDAN, UT 84095-7805
(385) 887-7351
(801) 442-0709
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(385) 887-7351
(801) 442-0709
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396852000
—
UT
01
—
2100193
PK
—
Enumeration date
08/25/2006
Last updated
01/29/2025
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