City of Benton

NPI #1417472739 in Benton, Illinois

Provider Information

NPI Number
1417472739
Entity Type
Organization
Organization Name
City of Benton
Primary Specialty
Ambulance - Land Transport
Enumeration Date
Aug 8, 2017
Last Updated
Nov 3, 2024

Practice Location

Address
107 N MAPLE ST
City
Benton
ZIP Code
62812-1368
Phone
(618) 439-2511

Authorized Official

Name
MR. SHANE TYLER COCKRUM
Title
FIRE CHIEF
Phone
(618) 439-2511

Specialties & Taxonomy Codes

Specialty
Ambulance - Land TransportLand Transport

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