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Organization
BENTON COUNTY GOVERNMENT
Active
Organization
BENTON COUNTY GOVERNMENT
Active
Other names
Benton County Emergency Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
JASON FISHER INDIANA CERTIFIED PA (EMS DIRECTOR)
(765) 884-2002
Entity
Organization
Contact information
Practice address
604 E 2ND ST, SUITE C, FOWLER, IN 47944
(765) 884-2002
(765) 884-2063
Mailing address
604 E 2ND ST, SUITE C, FOWLER, IN 47944
(765) 884-2002
(765) 884-2063
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
IN
341600000X
Ambulance
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100282190A
—
IN
Enumeration date
02/21/2007
Last updated
12/18/2012
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