Provider Demographics
NPI:1215977673
Name:COVENTRY TOWNSHIP
Entity type:Organization
Organization Name:COVENTRY TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:MURGATROYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-644-0785
Mailing Address - Street 1:25001 EMERY RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5621
Mailing Address - Country:US
Mailing Address - Phone:216-831-2300
Mailing Address - Fax:216-831-4130
Practice Address - Street 1:68 PORTAGE LAKES DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-2351
Practice Address - Country:US
Practice Address - Phone:330-644-0785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A FOR OHIO3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0518710Medicaid
OH0518710Medicaid