Provider Demographics
NPI:1205963105
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:CEO INTERMOUNTAIN MEDICAL GROUP
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LECKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-442-3974
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:435-716-2800
Mailing Address - Fax:
Practice Address - Street 1:1300 N 500 E #130
Practice Address - Street 2:LOGAN REGIONAL ORTHOPEDICS
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2466
Practice Address - Country:US
Practice Address - Phone:435-716-2800
Practice Address - Fax:435-716-2809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000055456Medicare PIN