Healthcare Provider Details

I. General information

NPI: 1437193646
Provider Name (Legal Business Name): CABUN RURAL HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 CHESTNUT STREET
LEWISVILLE AR
71845
US

IV. Provider business mailing address

PO BOX 1013
LEWISVILLE AR
71845-1013
US

V. Phone/Fax

Practice location:
  • Phone: 870-921-5781
  • Fax: 870-921-4510
Mailing address:
  • Phone: 870-921-5781
  • Fax: 870-921-4510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
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