Provider Demographics
NPI:1952870529
Name:HEXAGON ALLIANCE LLC
Entity Type:Organization
Organization Name:HEXAGON ALLIANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BABATOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:FATUYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-350-4305
Mailing Address - Street 1:8 DOMINION DR UNIT 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1315
Mailing Address - Country:US
Mailing Address - Phone:210-729-6222
Mailing Address - Fax:
Practice Address - Street 1:8 DOMINION DR UNIT 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1315
Practice Address - Country:US
Practice Address - Phone:210-729-6222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based