Provider Demographics
NPI:1457430142
Name:HAINS, SAN M (RT)
Entity Type:Individual
Prefix:MR
First Name:SAN
Middle Name:M
Last Name:HAINS
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 DYLAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461
Mailing Address - Country:US
Mailing Address - Phone:504-678-7989
Mailing Address - Fax:504-678-7698
Practice Address - Street 1:U S COAST GUARD
Practice Address - Street 2:2100 SECOND ST. SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:504-678-7989
Practice Address - Fax:504-678-7698
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other