Provider Demographics
NPI:1053367631
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:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VANWAGENEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-387-3740
Mailing Address - Street 1:2075 N 1200 W
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-1616
Mailing Address - Country:US
Mailing Address - Phone:801-779-6200
Mailing Address - Fax:801-779-6294
Practice Address - Street 1:2075 N 1200 W
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1616
Practice Address - Country:US
Practice Address - Phone:801-779-6200
Practice Address - Fax:801-779-6294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT383247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty