Primary Childrens Outpatient Pharmacy
LBN: Ihc Health Services Inc
Primary Childrens Outpatient Pharmacy is an health care organization with primary practice located at 100 N Mario Capecchi Dr , Salt Lake City UT 84113-1103. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Ihc Health Services Inc can be contacted via phone (801) 662-1680, or through Berensen, Nannette via phone (801) 507-8002.
Contact Information
Primary practice address
100 N Mario Capecchi Dr
Salt Lake City UT 84113-1103
Phone: (801) 662-1680
Fax: (801) 662-1688
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 49062421703 | Utah |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1790892404 |
|---|---|
| LBN Legal business name | Ihc Health Services Inc |
| DBA Doing business as | Primary Childrens Outpatient Pharmacy |
| Authorized official | Berensen, Nannette |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Aug 25th, 2006 |
| Last updated | Feb 21st, 2024 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790892404 | NPPES |
| Alaska | MEDICAID | 1790892404 | |
| Alaska | MEDICAID | 1790892404 | |
| Alaska | MEDICAID | 1790892404 | |
| Alaska | MEDICAID | 1790892404 | |
| Alaska | MEDICAID | 1790892404 | |
| Alaska | MEDICAID | 1790892404 | |
| Alaska | Other | 2107682 |
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