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General NPI Number Information
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NPI Number | 1972483964
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Entity Type | Organization
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Legal Business Name | HATHOR INC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 69 MONTHAVEN DR
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3361
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Country | US
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Telephone | 919-397-5242
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Fax |
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Provider Business Mailing Address
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Address Line | 69 MONTHAVEN DR
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3361
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Country | US
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Telephone | 919-397-5242
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Fax |
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Authorized Official
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Title or Position | AGENCY ADMINISTRATOR
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Name | TOLULOPE IDRIS
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Credential |
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Telephone | 919-397-5242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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