Provider Demographics
NPI:1710072897
Name:CITY OF CONNEAUT
Entity Type:Organization
Organization Name:CITY OF CONNEAUT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOCKADAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-593-7426
Mailing Address - Street 1:294 MAIN ST
Mailing Address - Street 2:CONNEAUT RESC SQUAD, CITY HALL
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-2650
Mailing Address - Country:US
Mailing Address - Phone:440-593-7426
Mailing Address - Fax:440-593-2845
Practice Address - Street 1:294 MAIN ST
Practice Address - Street 2:CONNEAUT RESC SQUAD, CONNEAUT FIRE DEPARTMENT
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-2650
Practice Address - Country:US
Practice Address - Phone:440-593-7426
Practice Address - Fax:440-593-2845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0150634Medicaid
OH590031274OtherPALMETTO GBA-RAILROAD MED
OH9112221Medicare PIN