Healthcare Provider Details

I. General information

NPI: 1962403295
Provider Name (Legal Business Name): ORTONVILLE AREA HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MARK DRIVE
ORTONVILLE MN
56278
US

IV. Provider business mailing address

201 MARK DRIVE
ORTONVILLE MN
56278-9999
US

V. Phone/Fax

Practice location:
  • Phone: 320-839-2502
  • Fax: 320-839-4105
Mailing address:
  • Phone: 320-839-2502
  • Fax: 320-839-4105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number328420
License Number StateMN

VIII. Authorized Official

Name: DR. ALLAN ROSS
Title or Position: CEO
Credential: MD
Phone: 320-839-2502