MEDICARE: MARK HAYNES RETAIL FURNITURE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		AL

General Provider Information

NPI Number	:	1225190036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK HAYNES RETAIL FURNITURE

Provider Business Mailing Address
First Line	:	5089 TAMMY LITTLE DR
Second Line	:
City	:	SECTION
State	:	AL
Zip	:	35771-7244
Country	:	US
Telephone Number	:	256-228-3577
Fax Number	:	256-228-3577

Provider Business Practice Location Address
First Line	:	5089 TAMMY LITTLE DR
Second Line	:
City	:	SECTION
State	:	AL
Zip	:	35771-7244
Country	:	US
Telephone Number	:	256-228-3577
Fax Number	:	256-228-3577

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	07/08/2007

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Directions to “ MARK HAYNES RETAIL FURNITURE” Practice Location

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