Provider Demographics
NPI:1245638402
Name:VILLAGE OF CONVOY
Entity type:Organization
Organization Name:VILLAGE OF CONVOY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHLEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-749-2997
Mailing Address - Street 1:PO BOX 392907
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9907
Mailing Address - Country:US
Mailing Address - Phone:800-962-1484
Mailing Address - Fax:513-772-4464
Practice Address - Street 1:117 FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:CONVOY
Practice Address - State:OH
Practice Address - Zip Code:45832
Practice Address - Country:US
Practice Address - Phone:419-203-1562
Practice Address - Fax:419-749-4138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0138288Medicaid
OHP01444936OtherRAILROAD MEDICARE
OH0138288Medicaid