Provider Demographics
NPI:1629466750
Name:IHC HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:IHC HEALTH SERVICES, INC
Other - Org Name:INTERMOUNTAIN HOMECARE HOME HEALTH FILLMORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AVP
Authorized Official - Prefix:
Authorized Official - First Name:CARTER
Authorized Official - Middle Name:
Authorized Official - Last Name:DREDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-887-6000
Mailing Address - Street 1:11520 S REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-7805
Mailing Address - Country:US
Mailing Address - Phone:387-887-6000
Mailing Address - Fax:
Practice Address - Street 1:25 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:UT
Practice Address - Zip Code:84631-4507
Practice Address - Country:US
Practice Address - Phone:435-743-5430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health