340B Drug Pricing Program Database

Pharmacy Name

IHC HEALTH SERVICES, INC.

Pharmacy Address

DBA: INTERMOUNTAIN PHARMACY #132
4401 HARRISON BLVD
OGDEN, UT 84403

Pharmacy Comments

Approval Date

6/5/2020

Contract Begin Date

6/15/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/2/2021
Pharmacy closed

Covered Entity Signing Official

Trever Porter, Finance Dir-MK
(801) 387-3767

Contract Pharmacy Representative

Intermountain Healthcare
Sabrina Cole, Executive Operations Director, System Pharmacy Services
(801) 284-1002

Signed By Date

5/29/2020