Provider Demographics
NPI:1205864741
Name:IHC HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:IHC HEALTH SERVICES, INC
Other - Org Name:CALTON-HARRISON CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN WAGENEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-387-3470
Mailing Address - Street 1:4403 HARRISON BLVD
Mailing Address - Street 2:STE 2400
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-3271
Mailing Address - Country:US
Mailing Address - Phone:801-387-2750
Mailing Address - Fax:801-387-2755
Practice Address - Street 1:4403 HARRISON BLVD
Practice Address - Street 2:STE 2400
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-3271
Practice Address - Country:US
Practice Address - Phone:801-387-2750
Practice Address - Fax:801-387-2755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty