Active NPI
Ihc Health Services Inc
- Community/Retail Pharmacy
- Murray, UT
National Provider Identifier
1558458752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 96835051703
- Legal business name
- IHC HEALTH SERVICES INC
- Practice address
- 181 E Medical Tower Dr
Murray, UT 84107-4872 - Phone
- (801) 314-2325
- Fax
- (801) 314-2143
- NPI assigned
- Oct 7, 2006
- Organization subpart
- Yes
- Parent organization
- IHC HEALTH SERVICES INC
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 96835051703 | UT | Primary |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
181 E Medical Tower Dr
Murray, UT 84107-4872
Mailing address
PO Box 30013
Salt Lake City, UT 84130-0013
Phone (801) 314-2325
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2107871 | Other | PK | |
| 1558458752 | Medicaid | UT |
Other names 1
- Intermountain Pharmacy #531
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 3
| 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 |
| O20080610000303 | UT | Part B Supplier - Clinic/Group Practice | 1850209420 |
Receives reassigned benefits from 4,146 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… |
Other NPIs on the same Medicare enrollment 26
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Bradley S Thompson DO
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160179200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1531958400000",
"number": "1558458752",
"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": "801-314-2325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 E MEDICAL TOWER DR",
"city": "MURRAY",
"state": "UT",
"postal_code": "841074872",
"telephone_number": "801-314-2325",
"fax_number": "801-314-2143"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IHC HEALTH SERVICES INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "IHC HEALTH SERVICES INC",
"enumeration_date": "2006-10-07",
"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": "96835051703",
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2107871",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1558458752",
"state": "UT"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Intermountain Pharmacy #531",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Murray, 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.