Mainline Health Systems Inc | |
557 Kirkwood Rd Star City AR 71667-8843 | |
(870) 628-5110 | |
(855) 854-6281 |
Full Name | Mainline Health Systems Inc |
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Speciality | Clinic/Center |
Location | 557 Kirkwood Rd, Star City, 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 |
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Mainline Health Systems Inc Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Mainline Health Systems Inc 557 Kirkwood Rd Star City AR 71667-8843 Ph: (870) 628-5110 |
NPI Number | 1649679051 |
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Provider Enumeration Date | 08/21/2014 |
Last Update Date | 05/15/2025 |
Medicare PECOS PAC ID | 5193785590 |
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Medicare Enrollment ID | O20241105000486 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649679051 | NPI | - | NPPES |
205925631 | 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: 400 E Arkansas St, Star City, AR 71667 Phone: 870-628-5110 Fax: 855-854-6281 | |
Monticello Dental Center Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 W Bradley St, Star City, AR 71667 Phone: 870-628-5131 | |
Mainline Health Systems, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 Ashley St., Star City, AR 71667 Phone: 650-419-2545 Fax: 855-854-6281 |