Organization
LAVACA FAMILY CLINIC
Active
Parent organization
BOONVILLE COMMUNITY HOSPITAL INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOONVILLE COMMUNITY HOSPITAL INC
Authorized official
DZAIDI DAUD (CEO)
(479) 675-2800
Entity
Organization
Contact information
Practice address
1000 W MAIN ST, LAVACA, AR 72941-3530
(479) 674-9181
Mailing address
880 W MAIN ST, BOONEVILLE, AR 72927-3420
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/18/2008
Last updated
09/08/2009
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