Provider Demographics
NPI:1265674246
Name:IHC HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:IHC HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICARE ENROLLMENT SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-442-8468
Mailing Address - Street 1:4646 LAKE PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-8212
Mailing Address - Country:US
Mailing Address - Phone:801-442-8468
Mailing Address - Fax:801-442-0066
Practice Address - Street 1:4646 LAKE PARK BLVD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-8212
Practice Address - Country:US
Practice Address - Phone:801-442-1466
Practice Address - Fax:801-442-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty