Healthcare Provider Details

I. General information

NPI: 1477496388
Provider Name (Legal Business Name): MS. KATE ROMA BELARGA JOSUE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 N LANDMARK DR
PARK CITY UT
84098-5990
US

IV. Provider business mailing address

6545 N LANDMARK DR
PARK CITY UT
84098-5990
US

V. Phone/Fax

Practice location:
  • Phone: 435-647-9040
  • Fax: 435-647-9042
Mailing address:
  • Phone: 435-647-9040
  • Fax: 435-647-9042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10072795-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: