Organization
IHC HEALTH SERVICES INC
Active
Other names
ALTA VIEW HOSPITAL OUTPATIENT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL WAGNER (OUTPATIENT PHARMACY MANAGER)
(801) 442-3903
Entity
Organization
Contact information
Practice address
9660 S 1300 E, SANDY, UT 84094-3762
(801) 501-2741
(801) 501-2710
Mailing address
PO BOX 30013, SALT LAKE CITY, UT 84130-0013
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
54204461703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4605234
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
942854058189
—
UT
Enumeration date
08/25/2006
Last updated
02/28/2008
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