Organization
IHC HEALTH SERVICES INC
Active
Organization
IHC HEALTH SERVICES INC
Active
Other names
Intermountain Health Home Medical Equipment Salt Lake Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARK PROVAN (VP-HOMECARE HOSPICE PALLIATIVE CARE)
(801) 442-2000
Entity
Organization
Contact information
Practice address
389 S 900 E, SALT LAKE CITY, UT 84102-2310
(385) 282-2200
Mailing address
11520 S REDWOOD ROAD, SOUTH JORDAN, UT 84095
(385) 887-6000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851715049
—
UT
Enumeration date
02/10/2014
Last updated
01/29/2025
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