| Mainline Health Systems, Inc | |
|
2018 Lady Jack Drive Warren AR 71671 | |
| (870) 226-6754 | |
| (870) 226-7925 |
| Full Name | Mainline Health Systems, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2018 Lady Jack Drive, Warren, 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 Health Systems, Inc Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Mainline Health Systems, Inc 2018 Lady Jack Drive Warren AR 71671 Ph: (870) 226-6754 |
| NPI Number | 1386322766 |
|---|---|
| Provider Enumeration Date | 07/06/2023 |
| Last Update Date | 08/06/2025 |
| Medicare PECOS PAC ID | 5193785590 |
|---|---|
| Medicare Enrollment ID | O20230803004206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386322766 | NPI | - | NPPES |
| 308781749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mainline Health Systems, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2018 Lady Jack Drive, Warren, AR 71638 Phone: 870-466-8450 Fax: 877-456-0923 | |
Mainline Health Systems, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 931 N Myrtle St, Building D, Warren, AR 71671 Phone: 870-355-2512 Fax: 855-754-0598 | |
Donnie R. Bryant, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 W Church St, Warren, AR 71671 Phone: 870-226-6556 Fax: 870-226-6150 |