Provider Demographics
NPI:1699926030
Name:VAN BUREN INC
Entity type:Organization
Organization Name:VAN BUREN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VP AND GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-818-0563
Mailing Address - Street 1:PO BOX 1712
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72957-1712
Mailing Address - Country:US
Mailing Address - Phone:479-474-3401
Mailing Address - Fax:
Practice Address - Street 1:EAST MAIN AND SOUTH 20TH STREET
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72957
Practice Address - Country:US
Practice Address - Phone:479-474-3401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty