Provider Demographics
NPI:1073908521
Name:CABUN RURAL HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:CABUN RURAL HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHEPPARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:870-798-4064
Mailing Address - Street 1:402 LEE STREET
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:AR
Mailing Address - Zip Code:71744-1196
Mailing Address - Country:US
Mailing Address - Phone:870-798-4064
Mailing Address - Fax:870-798-4100
Practice Address - Street 1:402 LEE STREET
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:AR
Practice Address - Zip Code:71744-1196
Practice Address - Country:US
Practice Address - Phone:870-798-4064
Practice Address - Fax:870-798-4100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR22151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR041824Medicare Oscar/Certification