MEDICARE: RANDALL HAYES

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	246RP1900X	Phlebotomy Technician	S9T2D9Z3	AL

General Provider Information

NPI Number	:	1629830906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDALL HAYES

Provider Business Mailing Address
First Line	:	2850 S JONES BLVD STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5640
Country	:	US
Telephone Number	:	702-245-3060
Fax Number	:	702-447-5524

Provider Business Practice Location Address
First Line	:	2850 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5639
Country	:	US
Telephone Number	:	702-245-3060
Fax Number	:

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

Provider Enumeration Date	:	01/23/2024
Last Update Date	:	01/23/2024

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Directions to “ RANDALL HAYES ” Practice Location

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