Organization
IHC HEALTH SERVICES INC
Active
Parent organization
IHC HEALTH SERVICES INC
Other names
Intermountain Pharmacy #656
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
9450 S 1300 E, SANDY, UT 84094-5555
(801) 501-2525
(801) 501-2530
Mailing address
PO BOX 30013, SALT LAKE CITY, UT 84130-0013
(801) 501-2525
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
10568911-1703
UT
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447367164
—
UT
01
—
2100774
PK
—
Enumeration date
08/25/2006
Last updated
07/19/2018
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