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General NPI Number Information
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NPI Number | 1922143239
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Entity Type | Organization
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Legal Business Name | BENTON COUNTY GOVERNMENT
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 604 E 2ND ST SUITE C
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City | FOWLER
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State | IN
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Zip | 47944
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Country | US
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Telephone | 765-884-2002
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Fax | 765-884-2063
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Provider Business Mailing Address
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Address Line | 604 E 2ND ST SUITE C
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City | FOWLER
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State | IN
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Zip | 47944
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Country | US
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Telephone | 765-884-2002
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Fax | 765-884-2063
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | JASON FISHER
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Credential | INDIANA CERTIFIED PA
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Telephone | 765-884-2002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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