Healthcare Provider Details

I. General information

NPI: 1801087986
Provider Name (Legal Business Name): ORION BLOSSOM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 12/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 BLOSSOM LN
SALEM OH
44460-4284
US

IV. Provider business mailing address

1 EASTON OVAL STE 300
COLUMBUS OH
43219-6062
US

V. Phone/Fax

Practice location:
  • Phone: 330-337-3033
  • Fax:
Mailing address:
  • Phone: 614-416-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateOH

VIII. Authorized Official

Name: DONALD D. FINNEY
Title or Position: PRESIDENT
Credential:
Phone: 614-416-0600