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IHC HEALTH SERVICES, INC.
HM84113 IHC HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
IHC HEALTH SERVICES, INC.
Subdivision Name
DBA PRIMARY CHILDREN'S HOSPITAL - ON BEHALF OF Utah Center for Bleeding and Clotting Disorders
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM84113
Entity Address
Primary Children's Hospital, 100 N MARIO CAPECCHI DRIVE
SALT LAKE CITY, UT 84113
Grant Number
H30MC24049
Participating Start Date
7/1/2009
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
IHC HEALTH SERVICES, INC.
Pharmacy Address
DBA INTERMOUNTAIN HEALTH INFUSION PHARMA
11520 SOUTH REDWOOD ROAD
SOUTH JORDAN, UT 84095
Pharmacy Comments
Contract Details
Approval Date
7/1/2009
Contract Begin Date
7/1/2009
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Intermountain Homecare Pharmacy
MARK CROSBY, PHARMACY DIRECTOR
(801) 887-6793
Signed By Date
6/25/2009
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