| Mainline Health Systems, Inc | |
|
566 S Mabry St Eudora AR 71640-2941 | |
| (870) 201-2127 | |
| (888) 671-8943 |
| Full Name | Mainline Health Systems, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 566 S Mabry St, Eudora, 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 566 S Mabry St Eudora AR 71640-2941 Ph: (870) 201-2127 |
| NPI Number | 1619415460 |
|---|---|
| Provider Enumeration Date | 02/01/2017 |
| Last Update Date | 05/15/2025 |
| Medicare PECOS PAC ID | 5193785590 |
|---|---|
| Medicare Enrollment ID | O20171107000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619415460 | NPI | - | NPPES |
| 223564749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
West Carroll Health Systems Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 S Main Street, Eudora, AR 71640 Phone: 870-355-2300 Fax: 870-355-6323 |