Organization
IHC HEALTH SERVICES INC
Active
Parent organization
IHC HEALTH SERVICES INC
Other names
MANTI 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
159 N MAIN ST, MANTI, UT 84642-1257
(435) 835-4225
(435) 835-4227
Mailing address
PO BOX 30013, SALT LAKE CITY, UT 84130-0013
(435) 835-4225
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
61361651703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467549667
—
UT
01
—
2100897
PK
—
Enumeration date
10/07/2006
Last updated
07/19/2018
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