Provider Demographics
NPI:1770138919
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:CHEIF INFORMATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-798-4064
Mailing Address - Street 1:200 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-8203
Mailing Address - Country:US
Mailing Address - Phone:870-722-2733
Mailing Address - Fax:870-798-4100
Practice Address - Street 1:200 E 18TH ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-8203
Practice Address - Country:US
Practice Address - Phone:870-722-2733
Practice Address - Fax:870-798-4100
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CABUN RURAL HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty