Provider Demographics
NPI:1689882557
Name:INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC
Entity Type:Organization
Organization Name:INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC
Other - Org Name:INTERMOUNTAIN HEALTH HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-668-4929
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:700 E SILVERADO RANCH BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-7516
Practice Address - Country:US
Practice Address - Phone:702-260-4231
Practice Address - Fax:702-270-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health