| Mainline Uam Medical Clinic | |
|
136 University Ct Monticello AR 71655 | |
| (870) 367-6241 | |
| (855) 926-7383 |
| Full Name | Mainline Uam Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 136 University Ct, Monticello, Arkansas |
| Authorized Official Name and Position | Gary Allan Nichols (CEO) |
| Authorized Official Contact | 8709423000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mainline Uam Medical Clinic Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Mainline Uam Medical Clinic 136 University Ct Monticello AR 71655 Ph: (870) 367-6241 |
| NPI Number | 1861156481 |
|---|---|
| Provider Enumeration Date | 10/29/2021 |
| Last Update Date | 09/18/2024 |
| Certification Date | 09/18/2024 |
| Medicare PECOS PAC ID | 5193785590 |
|---|---|
| Medicare Enrollment ID | O20220527002236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861156481 | NPI | - | NPPES |
| 287099749 | Medicaid | AR |
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