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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