Provider Demographics
NPI:1336935618
Name:CABUCK COMMUNITY CLINIC
Entity type:Organization
Organization Name:CABUCK COMMUNITY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-303-4019
Mailing Address - Street 1:13 CABUCK LN
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-7402
Mailing Address - Country:US
Mailing Address - Phone:318-303-4019
Mailing Address - Fax:318-303-4184
Practice Address - Street 1:13 CABUCK LN
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-7402
Practice Address - Country:US
Practice Address - Phone:318-303-4019
Practice Address - Fax:318-303-4184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health