Healthcare Provider Details

I. General information

NPI: 1013826049
Provider Name (Legal Business Name): JAVA KALATI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAVANEH KALATI

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14438 S ROSE SUMMIT DR
HERRIMAN UT
84096-3445
US

IV. Provider business mailing address

14438 S ROSE SUMMIT DR
HERRIMAN UT
84096-3445
US

V. Phone/Fax

Practice location:
  • Phone: 801-888-7970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13552572-1702
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: