Provider Demographics
| NPI: | 1437169497 |
|---|---|
| Name: | IHC HEALTH SERVICES INC |
| Entity type: | Organization |
| Organization Name: | IHC HEALTH SERVICES INC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | DENIS |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | SMITH |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 801-442-2000 |
| Mailing Address - Street 1: | PO BOX 30180 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SALT LAKE CITY |
| Mailing Address - State: | UT |
| Mailing Address - Zip Code: | 84130-0180 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1380 E MEDICAL CENTER DR |
| Practice Address - Street 2: | |
| Practice Address - City: | ST GEORGE |
| Practice Address - State: | UT |
| Practice Address - Zip Code: | 84790-2123 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 435-251-1000 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-08-09 |
| Last Update Date: | 2023-09-14 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 207L00000X, 207P00000X, 207Q00000X, 207R00000X, 207RC0000X, 207RC0001X, 2085R0202X, 208600000X, 207RI0011X, 207W00000X, 208100000X, 2084N0400X, 363A00000X, 363L00000X | ||
| UT | 2005-HOSP-178 | 261QM1300X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | Group - Multi-Specialty |
| No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
| No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| UT | 000006456 | Medicare PIN | |
| UT | 000006455 | Medicare PIN | |
| UT | U000006079 | Medicare PIN | |
| UT | 006512000 | Medicare PIN | |
| UT | 000006714 | Medicare PIN | |
| UT | 000006983 | Medicare PIN |