# CITY OF BENTON

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** City of Benton Fire Department
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417472739
- **Authorized official:** MR. SHANE TYLER COCKRUM (FIRE CHIEF)
- **Authorized official phone:** (618) 439-2511

## Contact information

- **Practice address:** 107 N MAPLE ST, BENTON, IL 62812-1368
- **Practice address phone:** (618) 439-2511
- **Mailing address:** 107 N MAPLE ST, BENTON, IL 62812-1368

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 055496 | IL | Yes |

## Other

- **Enumeration date:** 08/08/2017
- **Last updated:** 11/03/2024