MEDICARE: AMG HOSPICE OF UTAH LLC

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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1750121216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMG HOSPICE OF UTAH LLC

Provider Business Mailing Address
First Line	:	738 N 3275 W
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84041-3321
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	738 N 3275 W
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84041-3321
Country	:	US
Telephone Number	:	208-230-0314
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID W NATTRESS
Credential	:
Telephone Number	:	208-761-7170

Provider Enumeration Date	:	05/30/2024
Last Update Date	:	12/10/2025

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