Provider Demographics
NPI:1497886063
Name:BENTON VOLUNTEER FIRE COMPANY
Entity Type:Organization
Organization Name:BENTON VOLUNTEER FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:MUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-925-5542
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:PA
Mailing Address - Zip Code:17814-0252
Mailing Address - Country:US
Mailing Address - Phone:570-925-5542
Mailing Address - Fax:
Practice Address - Street 1:150 COLLEY ST.
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:PA
Practice Address - Zip Code:17814
Practice Address - Country:US
Practice Address - Phone:570-925-5542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007000090002Medicaid
PA0007000090002Medicaid