=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467918201
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HARTORIA HEALTH SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2019
-----------------------------------------------------
Last Update Date | 10/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3161 CUSTER DR STE 3
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40517-4067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-368-0434
-----------------------------------------------------
Fax | 859-368-0437
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3161 CUSTER DR STE 3
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40517-4067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-368-0434
-----------------------------------------------------
Fax | 859-368-0437
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JESUS VICTOR TOVAR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 859-368-0434
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QA0401X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------