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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