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CAH461307-01 IHC Health Services Inc. DBA Intermountain Health Heber Valley Hospital (Active)
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Main Details
Name
IHC Health Services Inc. DBA Intermountain Health Heber Valley Hospital
Subdivision Name
Renal Dialysis
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH461307-01
Medicare Provider Number
461307
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/15/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/16/2015
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Heber Valley Hospital
Jennilyn Ferry, Finance Director
(435) 658-6709
Primary Contact
IHC Health Services, Inc.
Kevin Forbush, 340B Program Director
(385) 429-2887
Addresses
Street Address
380 East 1500 South STE 101
Heber City, UT 84032
Billing Address
IHC Health Services Inc. DBA: Heber Valley Hospital
454 E Medical Way
Heber City, UT 84032
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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