Healthcare Provider Details

I. General information

NPI: 1225288681
Provider Name (Legal Business Name): HAYNES AMBULANCE OF TROY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S BRUNDIDGE ST
TROY AL
36081-3334
US

IV. Provider business mailing address

PO BOX 1515
WETUMPKA AL
36092-0028
US

V. Phone/Fax

Practice location:
  • Phone: 334-265-1208
  • Fax: 334-567-6850
Mailing address:
  • Phone: 334-241-5224
  • Fax: 334-567-6850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MRS. BRANDEE H BARRETT
Title or Position: MEMBER
Credential: EMT-P
Phone: 334-241-5224