Ihc Health Services Inc

Organization Active NPI Family Medicine Physician · South Jordan, UT

NPI 1871990309 · NPPES record last updated Feb 10, 2015

Key facts

NPI
1871990309
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
770172014 (UT)
Legal business name
IHC HEALTH SERVICES INC
Practice address
1067 W South Jordan Pkwy
South Jordan, UT 84095-8809
Phone
(385) 887-7200
NPI assigned
Nov 26, 2014
Organization subpart
No

Authorized official

Name
Linda C Leckman, MD
Title
Ceo Intermountain Medical Group
Phone
(801) 442-3974

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Tax ID family
Bradley S Thompson DO (479 organizations share this tax ID)

Locations

1091 W South Jordan Pkwy
Ste 500
South Jordan, UT 84095
Phone (385) 887-7200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 770172014 UT Yes

Addresses

Primary practice location

1067 W South Jordan Pkwy
South Jordan, UT 84095-8809

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (385) 887-7200

Other names

  • South Jordan WorkMed Other name

Other providers in South Jordan, UT

All providers in South Jordan, UT · Family Medicine Physician in Utah

Sources for this page

Verify at the official NPI Registry.