NPIMap

Organization Active NPI

Ihc Health Services Inc

  • Community/Retail Pharmacy
  • Salt Lake City, UT
National Provider Identifier
1144337304
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
57703861703 Issued in UT
Legal business name
IHC HEALTH SERVICES INC
Practice address
2000 S 900 E
Salt Lake City, UT 84105-3208
Phone
(801) 464-7800
Fax
(801) 464-7812
NPI assigned
Aug 24, 2006
Organization subpart
Yes
Parent organization
IHC HEALTH SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 57703861703 UT Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

2000 S 900 E
Salt Lake City, UT 84105-3208

Mailing address

PO Box 30013
Salt Lake City, UT 84130-0013
Phone (801) 464-7800

Other identifiers 2

IdentifierTypeStateIssuer
1144337304MedicaidUT
2101176OtherPK

Other names 1

  • IHC HEALTH CENTER PHARMACY MEMORIAL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091117000671 UT Part B Supplier - Mass Immunization (Roster Biller Only) 1850209420 26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Provo, UT; Richfield, UT; Riverton, UT; Roy, UT; Salina, UT; Salt Lake City, UT; Sandy, UT; St George, UT…

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

National Provider Directory

National Provider Directory
Tax ID family
Bradley S Thompson DO479 organizations share this tax ID, including this one
Part of
Bradley S Thompson DO

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1144337304",
    "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": "801-464-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053208",
            "telephone_number": "801-464-7800",
            "fax_number": "801-464-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IHC HEALTH SERVICES INC",
        "enumeration_date": "2006-08-24",
        "last_updated": "2018-07-19",
        "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": "UT",
            "license": "57703861703",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144337304",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2101176",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IHC HEALTH CENTER PHARMACY MEMORIAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.