Ihc Health Services Inc

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

Legal business name

IHC HEALTH SERVICES INC

Doing business as

Intermountain Home Delivery Pharmacy
Intermountain Specialty Pharmacy

Practice address

7268 S Bingham Junction Blvd Ste B1
Midvale, UT 84047-4860

Phone

(801) 284-1114

Fax

(801) 284-1115

NPI assigned

Feb 27, 2014

Last updated

May 29, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

IHC HEALTH SERVICES INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nannette Berensen

Title

Vice President of Clinical Systems

Phone

(801) 284-1005

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 2

• Intermountain Home Delivery Pharmacy Doing business as
• Intermountain Specialty Pharmacy Doing business as

Part of

Robert E Fowles MD

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1093130031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30013",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300013",
            "telephone_number": "801-284-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7268 S BINGHAM JUNCTION BLVD STE B1",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840474860",
            "telephone_number": "801-284-1114",
            "fax_number": "801-284-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IHC HEALTH SERVICES INC",
        "enumeration_date": "2014-02-27",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "BERENSEN",
        "authorized_official_first_name": "NANNETTE",
        "authorized_official_title_or_position": "VICE PRESIDENT OF CLINICAL SYSTEMS",
        "authorized_official_telephone_number": "801-284-1005"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144451",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093130031",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093130031",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Home Delivery Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaitlin Huckaby, LCMHC
• Cailin Miranda Hughes
• Matthew Humphrey
• Blake Hunt
• Bonnie Hyde
• Ihc Health Services Inc (Intermountain Home Delivery Pharmacy)
• Ihc Health Services Inc (Alta View Center for Counseling)
• Ihc Health Services Inc (Midvale ExpressCare)
• Ihc Health Services Inc (TeleHealth eVisit)
• Justin Alan Illum

• Specialty Pharmacy in Midvale, UT
• Providers in Midvale, UT by specialty
• Specialty Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.