MEDICARE: ORRVILLE HOSPITAL FOUNDATION

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	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1376172866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORRVILLE HOSPITAL FOUNDATION

Provider Business Mailing Address
First Line	:	PO BOX 80690
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-0690
Country	:	US
Telephone Number	:	330-363-7444
Fax Number	:

Provider Business Practice Location Address
First Line	:	10724 STATE ROUTE 212 NE
Second Line	:
City	:	BOLIVAR
State	:	OH
Zip	:	44612-8740
Country	:	US
Telephone Number	:	330-874-7165
Fax Number	:	330-874-7166

Authorized Official
Title or Position	:	CFO
Name	:	ADAM M LUNTZ
Credential	:
Telephone Number	:	330-363-3889

Provider Enumeration Date	:	04/06/2020
Last Update Date	:	02/03/2025

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Directions to “ORRVILLE HOSPITAL FOUNDATION ” Practice Location

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