Organization Name: | IHC HEALTH SERVICES, INC. |
NPI Number: | 1134274947 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVE LARSEN (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 196 West 2000 North Suite 112 Tooele |
State: | UT US |
Postal Code: | 840742736 |
Phone Number: | 8014081430 |
Fax Number: | |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 02/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | 2005-ESRD-0608 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |