MEDICARE: HARTORIA HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0401X	Addiction Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1467918201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARTORIA HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	1618 HARRODSBURG RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3706
Country	:	US
Telephone Number	:	859-368-0434
Fax Number	:	859-368-0437

Provider Business Practice Location Address
First Line	:	1618 HARRODSBURG RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3706
Country	:	US
Telephone Number	:	859-368-0434
Fax Number	:	859-368-0437

Authorized Official
Title or Position	:	OPERATIONS DIRECTOR
Name	:	WILLIAM SLATEN
Credential	:
Telephone Number	:	859-537-8419

Provider Enumeration Date	:	02/18/2019
Last Update Date	:	02/18/2026

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