Organization
ETHRIDGE GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY T GENTILE (AUTHORIZED AGENT)
(860) 257-7080
Entity
Organization
Contact information
Practice address
10301 NORTHWEST FWY STE 205, HOUSTON, TX 77092-8225
(281) 445-7616
(713) 957-3200
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(860) 257-7080
(860) 563-3403
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
101502
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285396201
—
TX
Enumeration date
09/16/2010
Last updated
12/23/2011
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