Ihc Health Services Inc
Organization Active NPI Community/Retail Pharmacy · Ogden, UT
NPI 1356458079 · NPPES record last updated May 4, 2018
Key facts
- NPI
- 1356458079
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 56346761703 (UT)
- Legal business name
- IHC HEALTH SERVICES INC
- Practice address
- 975 E Chambers Ave
Ogden, UT 84403-4591 - Phone
- (801) 387-6300
- Fax
- (801) 387-6325
- NPI assigned
- Aug 25, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- IHC HEALTH SERVICES INC
Authorized official
- Name
- Nannette Berensen
- Title
- Vice President of Clinical Systems
- Phone
- (801) 284-1005
Other NPIs on the same Medicare enrollment 26
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031105000079 | UT | Part B Supplier - Clinic/Group Practice | 1850209420 |
Receives reassigned benefits from 1,923 practitioners This NPI is an additional NPI on the enrollment |
| 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… |
National Provider Directory
- Tax ID family
- Bradley S Thompson DO
- Part of
- Bradley S Thompson DO
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 56346761703 | UT | Yes |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
975 E Chambers Ave
Ogden, UT 84403-4591
Mailing address
PO Box 30013
Salt Lake City, UT 84130-0013
Phone (801) 387-6300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356458079 | Medicaid | UT | |
| 2100775 | Other | PK |
Other providers in Ogden, UT
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
All providers in Ogden, UT · Community/Retail Pharmacy in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.