MAINLINE HEALTH SYSTEMS INC NPI 1619082724

NPI Information

NPI: 1619082724
Provider Name: MAINLINE HEALTH SYSTEMS, INC

Doing Business As: EUDORA MEDICAL CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
579 E BEOUFF ST
EUDORA, AR
ZIP 71640
Phone: (870) 355-2512
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MAINLINE HEALTH SYSTEMS, INC is a federally qualified health center (fqhc) clinic center in Eudora, AR. MAINLINE HEALTH SYSTEMS, INC NPI is 1619082724. The provider is registered as an organization entity type.
The provider Is Doing Business As Eudora Medical Clinic.

The provider's business location address is:

579 E BEOUFF ST
EUDORA, AR
ZIP 71640-090
Phone: (870) 355-2512
Fax: (870) 355-2520

The provider's authorized official is Mary Scott .
The authorized official title is Cfo and has the following contact phone number (870) 737-2737.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 3/30/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	122646749	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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