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IHC HEALTH SERVICES, INC.
SCH460026-00 IHC HEALTH SERVICES, INC. DBA: Intermountain Health SEVIER VALLEY HOSPITAL
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Covered Entity Details
Entity Name
IHC HEALTH SERVICES, INC. DBA: Intermountain Health SEVIER VALLEY HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH460026-00
Entity Address
1000 NORTH MAIN ST
RICHFIELD, UT 84701
Medicare Provider Number
460026
Participating Start Date
7/1/2019
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
IHC HEALTH SERVICES, INC.
Pharmacy Address
DBA: INTERMOUNTAIN PHARMACY #142
530 N 250 W
SALINA, UT 84654-5514
Pharmacy Comments
Contract Details
Approval Date
7/3/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/17/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
CHRIS THOMPSON, C.F.O
(435) 893-0535
Contract Pharmacy Representative
Intermountain Healthcare
Sabrina Cole, Executive Operations Director, System Pharmacy Services
(801) 284-1002
Signed By Date
7/3/2019
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