Organization
IHC HEALTH SERVICES INC
Active
Other names
Intermountain Health Home Medical Equipment Bountiful
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
1440 S 500 W, WOODS CROSS, UT 84010-8143
(801) 294-0636
Mailing address
11520 S REDWOOD RD, SOUTH JORDAN, UT 84095-7805
(385) 887-6000
(801) 442-0603
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902113715
—
UT
Enumeration date
09/01/2010
Last updated
01/29/2025
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