MEDICARE: WASATCH REGIONAL HOME HEALTH & HOSPICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1386923571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASATCH REGIONAL HOME HEALTH & HOSPICE

Provider Business Mailing Address
First Line	:	2974 W 3500 S
Second Line	:	SUITE 600
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-3630
Country	:	US
Telephone Number	:	801-849-0696
Fax Number	:	801-542-0078

Provider Business Practice Location Address
First Line	:	2974 W 3500 S
Second Line	:	SUITE 600
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-3630
Country	:	US
Telephone Number	:	801-849-0696
Fax Number	:	801-542-0078

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CURTIS W LARSEN
Credential	:
Telephone Number	:	801-628-4575

Provider Enumeration Date	:	08/05/2011
Last Update Date	:	03/29/2013

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Directions to “WASATCH REGIONAL HOME HEALTH & HOSPICE ” Practice Location

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