Healthcare Provider Details

I. General information

NPI: 1649953290
Provider Name (Legal Business Name): HAYLEY DEBACKER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

876 E 800 S
SALT LAKE CITY UT
84102-3634
US

IV. Provider business mailing address

12297 S BOGGS WAY
HERRIMAN UT
84096-2982
US

V. Phone/Fax

Practice location:
  • Phone: 801-355-5257
  • Fax:
Mailing address:
  • Phone: 901-302-7513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14187684
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: