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
—
—
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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