Healthcare Provider Details

I. General information

NPI: 1750121216
Provider Name (Legal Business Name): AMG HOSPICE OF UTAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7070 S UNION PARK AVE STE 300
MIDVALE UT
84047-6061
US

IV. Provider business mailing address

7070 S UNION PARK AVE STE 300
MIDVALE UT
84047-6061
US

V. Phone/Fax

Practice location:
  • Phone: 801-421-0200
  • Fax: 801-421-0199
Mailing address:
  • Phone: 801-421-0200
  • Fax: 801-421-0199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVID W NATTRESS
Title or Position: PRESIDENT
Credential:
Phone: 208-761-7170