Organization
EDEN EMERGENCY SQUAD 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
2795 E CHURCH ST, EDEN, NY 14057-1280
(716) 992-4460
(716) 992-2068
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
1447
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03176721
—
NY
Enumeration date
06/08/2009
Last updated
04/26/2010
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