Provider Demographics
NPI:1306385810
Name:HAYNES PERSONAL LOGISTICS, LLC
Entity Type:Organization
Organization Name:HAYNES PERSONAL LOGISTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-639-6959
Mailing Address - Street 1:1020 RIGHT POOR VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24277-7019
Mailing Address - Country:US
Mailing Address - Phone:276-298-7295
Mailing Address - Fax:540-595-0897
Practice Address - Street 1:1020 RIGHT POOR VALLEY RD
Practice Address - Street 2:
Practice Address - City:PENNINGTON GAP
Practice Address - State:VA
Practice Address - Zip Code:24277-7019
Practice Address - Country:US
Practice Address - Phone:276-298-7295
Practice Address - Fax:540-595-0897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAIRCC316343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)