Provider Demographics
NPI:1568716694
Name:HAYES MEDICAL TRANSPORT, INC.
Entity Type:Organization
Organization Name:HAYES MEDICAL TRANSPORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DWAIN
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-993-3733
Mailing Address - Street 1:3884 NE HIGHWAY 70
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-2813
Mailing Address - Country:US
Mailing Address - Phone:863-993-3733
Mailing Address - Fax:863-993-3410
Practice Address - Street 1:3884 NE HIGHWAY 70
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-2813
Practice Address - Country:US
Practice Address - Phone:863-993-3733
Practice Address - Fax:863-993-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL430010600Medicaid
FLF592-201-909-002Medicaid
FL410012300Medicaid