MAINLINE HEALTH SYSTEMS INC NPI 1386758043

NPI Information

NPI: 1386758043
Provider Name: MAINLINE HEALTH SYSTEMS INC

Doing Business As: MAINLINE DERMOTT MEDICAL CLINC

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
300 S SCHOOL ST
DERMOTT, AR
ZIP 71638
Phone: (870) 538-5296
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MAINLINE HEALTH SYSTEMS INC is a federally qualified health center (fqhc) clinic center in Dermott, AR. MAINLINE HEALTH SYSTEMS INC NPI is 1386758043. The provider is registered as an organization entity type.
The provider Is Doing Business As Mainline Dermott Medical Clinc.

The provider's business location address is:

300 S SCHOOL ST
DERMOTT, AR
ZIP 71638-228
Phone: (870) 538-5296
Fax: (870) 538-3701

The provider's authorized official is Mary A 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 8/19/2006 and was last updated on 9/9/2021.

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	122645749	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: 4/28/2024

NPI Synchronization or Removal

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