| Mainline Rison | |
|
505 Sycamore St. Rison AR 71665 | |
| (870) 325-6255 | |
| (870) 663-4112 |
| Full Name | Mainline Rison |
|---|---|
| Speciality | Clinic/Center |
| Location | 505 Sycamore St., Rison, 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 Rison Po Box 509 Dermott AR 71638-0509 Ph: (870) 538-5414 | Mainline Rison 505 Sycamore St. Rison AR 71665 Ph: (870) 325-6255 |
| NPI Number | 1285105957 |
|---|---|
| Provider Enumeration Date | 12/06/2018 |
| Last Update Date | 07/10/2024 |
| Medicare PECOS PAC ID | 5193785590 |
|---|---|
| Medicare Enrollment ID | O20190108002875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285105957 | NPI | - | NPPES |
| 236578749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Rison Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 Sycamore, Rison, AR 71665 Phone: 870-325-6255 Fax: 870-325-6117 | |
Access Medical Clinic Arkansas Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 217 N Main St, Rison, AR 71665 Phone: 888-264-5034 Fax: 870-895-2164 |