Basic Information
| Provider Information | |||||||||
| NPI: | 1275724346 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ORION AUSTINBURG LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | AUSTINBURG NURSING AND REHABILITATION | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 EASTON OVAL STE 210 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432196224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144160600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2026 STATE ROUTE 45 | ||||||||
| Address2: | |||||||||
| City: | AUSTINBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440109711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402753019 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2007 | ||||||||
| LastUpdateDate: | 06/02/2010 | ||||||||
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| AuthorizedOfficialLastName: | FINNEY | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
| AuthorizedOfficialMiddleName: | D. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6144160600 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | OH | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 2738416 | 05 | OH | MEDICAID |