| Mainline Health Systems, Inc | |
|
134 South Strickland St Dermott AR 71638 | |
| (870) 538-5414 | |
| (870) 538-5412 |
| Full Name | Mainline Health Systems, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 134 South Strickland St, Dermott, Arkansas |
| Authorized Official Name and Position | Gary Allan Nichols (CEO) |
| Authorized Official Contact | 8709423000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mainline Health Systems, Inc Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Mainline Health Systems, Inc 134 South Strickland St Dermott AR 71638 Ph: (870) 538-5414 |
| NPI Number | 1669401501 |
|---|---|
| Provider Enumeration Date | 07/02/2006 |
| Last Update Date | 07/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669401501 | NPI | - | NPPES |
| 122649741 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Dermott Family Practice, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 N Freeman St, Dermott, AR 71638 Phone: 870-538-3800 |