MAINLINE HEALTH SYSTEMS INC NPI 1316106388

NPI Information

NPI: 1316106388
Provider Name: MAINLINE HEALTH SYSTEMS INC
Classification: Clinic/Center - 261QF0400X
Specialization: Federally Qualified Health Center (FQHC)
Entity Type: Organization
Doing Business As: PORTLAND HEALTH CARE
CLIA Number: 04D0465422
Address: 233 N MAIN ST
PORTLAND, AR
ZIP 71663
Phone: (870) 737-2221

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NPI Details

MAINLINE HEALTH SYSTEMS INC is a federally qualified health center (fqhc) clinic center in Portland, AR. MAINLINE HEALTH SYSTEMS INC NPI is 1316106388. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Portland Health Care.

The provider's business location address is:

233 N MAIN ST
PORTLAND, AR
ZIP 71663
Phone: (870) 737-2221
Fax: (855) 878-5991

The provider's authorized official is Gary Allan Nichols .
The authorized official title is Ceo and has the following contact phone number (870) 942-3000.

The CLIA number assigned to this NPI record is 04D0465422 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 6/5/2008 and was last updated on 9/18/2024.

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	103TB0200X	Psychologist	Cognitive & Behavioral			No
2	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	117615749	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: 11/21/2025

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