Provider Demographics
NPI:1578206462
Name:IHC HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:IHC HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND COO
Authorized Official - Prefix:
Authorized Official - First Name:NANNETTE
Authorized Official - Middle Name:MIGNON
Authorized Official - Last Name:BERENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-507-8002
Mailing Address - Street 1:1424 E FOREMASTER DR STE 120
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-5844
Mailing Address - Country:US
Mailing Address - Phone:801-906-2740
Mailing Address - Fax:
Practice Address - Street 1:1424 E FOREMASTER DR STE 120
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5844
Practice Address - Country:US
Practice Address - Phone:801-906-2740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IHC HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-18
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology