Provider Demographics
NPI:1194737460
Name:HAYNES AMBULANCE OF ALABAMA, INC
Entity type:Organization
Organization Name:HAYNES AMBULANCE OF ALABAMA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDEE
Authorized Official - Middle Name:HAYNES
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:334-241-5224
Mailing Address - Street 1:PO BOX 1515
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-0028
Mailing Address - Country:US
Mailing Address - Phone:334-265-1208
Mailing Address - Fax:
Practice Address - Street 1:2530 E 5TH ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36107-3106
Practice Address - Country:US
Practice Address - Phone:334-265-1208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL02673416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-52993OtherBLUE CROSS BLUE SHIELD AL