Healthcare Provider Details

I. General information

NPI: 1376583757
Provider Name (Legal Business Name): CABUN RURAL HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 09/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 SMITH RD
HOPE AR
71801-8971
US

IV. Provider business mailing address

PO BOX 1654
HOPE AR
71802-1654
US

V. Phone/Fax

Practice location:
  • Phone: 870-777-8420
  • Fax: 870-777-2390
Mailing address:
  • Phone: 870-777-8420
  • Fax: 870-888-2390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSAN DIANE JOHNSTON
Title or Position: BILLING SUPERVISOR
Credential: LPN, LRT, RMC
Phone: 870-798-3515