MAINLINE HEALTH SYSTEMS INC NPI 1891245809

NPI Information

NPI: 1891245809
Provider Name: MAINLINE HEALTH SYSTEMS, INC

Doing Business As: DERMOTT SCHOOL DENTAL CLINIC

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
525 E SPEEDWAY ST
DERMOTT, AR
ZIP 71638
Phone: (870) 538-5414
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MAINLINE HEALTH SYSTEMS, INC is a dental clinic center in Dermott, AR. MAINLINE HEALTH SYSTEMS, INC NPI is 1891245809. The provider is registered as an organization entity type.
The provider Is Doing Business As Dermott School Dental Clinic.

The provider's business location address is:

525 E SPEEDWAY ST
DERMOTT, AR
ZIP 71638-322
Phone: (870) 538-5414
Fax: (870) 538-5412

The provider's authorized official is Gary A Nichols .
The authorized official title is Executive Director and has the following contact phone number (870) 538-5414.

The enumeration date for this NPI number is 10/13/2016 and was last updated on 6/11/2020.

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	261QD0000X	Clinic/Center	Dental			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	217955631	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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