Healthcare Provider Details

I. General information

NPI: 1104033240
Provider Name (Legal Business Name): BENTON COUNTY FIRE DIST NO 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 DALE AVE
BENTON CITY WA
99320-8831
US

IV. Provider business mailing address

PO BOX 3510
SILVERDALE WA
98383-3510
US

V. Phone/Fax

Practice location:
  • Phone: 509-588-3212
  • Fax: 509-588-4343
Mailing address:
  • Phone: 360-394-7010
  • Fax: 360-394-7099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number03D02
License Number StateWA

VIII. Authorized Official

Name: MR. RONALD K DUNCAN JR.
Title or Position: FIRE CHIEF
Credential:
Phone: 509-588-3212