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Organization
CITY OF BENTON
Active
Organization
CITY OF BENTON
Active
Other names
City of Benton Fire Department
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHANE TYLER COCKRUM (FIRE CHIEF)
(618) 439-2511
Entity
Organization
Contact information
Practice address
107 N MAPLE ST, BENTON, IL 62812-1368
(618) 439-2511
Mailing address
107 N MAPLE ST, BENTON, IL 62812-1368
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
055496
IL
Other
Enumeration date
08/08/2017
Last updated
11/03/2024
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