NPIMap

Organization Active NPI

Ihc Health Services Inc

Doing business as Intermountain Home Delivery Pharmacy

  • Mail Order Pharmacy
  • Midvale, UT
National Provider Identifier
1508119918
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mail Order PharmacyTaxonomy code 3336M0002X
License
8858671-1703 Issued in UT
Legal business name
IHC HEALTH SERVICES INC
Doing business as
Intermountain Home Delivery Pharmacy
Intermountain Specialty Pharmacy
Practice address
7268 S Bingham Junction Blvd
Midvale, UT 84047-4860
Phone
(855) 779-3960
Fax
(801) 442-4179
NPI assigned
Oct 23, 2012
Last updated
May 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
IHC HEALTH SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Nannette Mignon Berensen
Title
Chief Operating Officer
Phone
(801) 507-8002

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X NU
Mail Order Pharmacy 3336M0002X 8858671-1703 UT Primary
Specialty Pharmacy 3336S0011X NU

Addresses

Primary practice location

7268 S Bingham Junction Blvd
Midvale, UT 84047-4860

Mailing address

PO Box 30013
Salt Lake City, UT 84130-0013
Phone (855) 779-3960

Other identifiers 3

IdentifierTypeStateIssuer
1508119918MedicaidUT
2137364OtherPK
1508119918MedicaidID

Other names 2

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

National Provider Directory

National Provider Directory
Tax ID family
Robert E Fowles MD482 organizations share this tax ID, including this one
Part of
Robert E Fowles MD

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

Locations

7268 S Bingham Junction Blvd
Midvale, UT 84047
Phone (801) 442-4191

NPI Registry JSON

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1508119918",
    "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": "855-779-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7268 S BINGHAM JUNCTION BLVD",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840474860",
            "telephone_number": "855-779-3960",
            "fax_number": "801-442-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IHC HEALTH SERVICES INC",
        "enumeration_date": "2012-10-23",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "BERENSEN",
        "authorized_official_first_name": "NANNETTE",
        "authorized_official_middle_name": "MIGNON",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "801-507-8002"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "UT",
            "license": "8858671-1703",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508119918",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137364",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508119918",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Home Delivery Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Home Delivery Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midvale, UT

Sources for this page

  • 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.