| NPI | 1396852000 |
|---|---|
| Doing Business As | INTERMOUNTAIN HEALTH INFUSION PHARMACY SALT LAKE |
| Doing Business As | INTERMOUNTAIN HEALTH INFUSION PHARMACY ST. GEORGE |
| Entity Type | Organization |
| Authorized Contact | MARK PROVAN VP Homecare Hospice Palliative Care 801-442-2000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2025-01-29 |