Healthcare Provider Details

I. General information

NPI: 1265723571
Provider Name (Legal Business Name): THE ORMSBY GROUP LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2011
Last Update Date: 04/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 EXCELSIOR BLVD STE. 403
ST LOUIS PARK MN
55416-4960
US

IV. Provider business mailing address

4601 EXCELSIOR BLVD STE. 403
ST LOUIS PARK MN
55416-4960
US

V. Phone/Fax

Practice location:
  • Phone: 952-236-3965
  • Fax:
Mailing address:
  • Phone: 952-236-3965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number352687
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number352687
License Number StateMN

VIII. Authorized Official

Name: MR. RUDOLPH HAMMA BLYTHE III
Title or Position: OWNER
Credential: M.A, M.B.A
Phone: 952-428-8343