Provider Demographics
NPI:1083797468
Name:JOANN C HAYS
Entity Type:Organization
Organization Name:JOANN C HAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-967-6494
Mailing Address - Street 1:PO BOX 1193
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811-1193
Mailing Address - Country:US
Mailing Address - Phone:479-967-6494
Mailing Address - Fax:479-967-6494
Practice Address - Street 1:1704 W C PL
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-2773
Practice Address - Country:US
Practice Address - Phone:479-967-6494
Practice Address - Fax:479-967-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-22
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49523OtherBLUE
1240750001Medicare NSC