Mainline Dermott Medical Clinc | |
300 S School St Dermott AR 71638-2228 | |
(870) 538-5296 | |
(870) 538-3701 |
Full Name | Mainline Dermott Medical Clinc |
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Speciality | Clinic/Center |
Location | 300 S School St, Dermott, Arkansas |
Authorized Official Name and Position | Mary A Scott (CFO) |
Authorized Official Contact | 8707372737 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mainline Dermott Medical Clinc Po Box 100 Portland AR 71663-0100 Ph: (870) 737-2737 | Mainline Dermott Medical Clinc 300 S School St Dermott AR 71638-2228 Ph: (870) 538-5296 |
NPI Number | 1386758043 |
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Provider Enumeration Date | 08/19/2006 |
Last Update Date | 09/09/2021 |
Medicare PECOS PAC ID | 5193785590 |
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Medicare Enrollment ID | O20080324000149 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386758043 | NPI | - | NPPES |
122645749 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Dermott School Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 525 E Speedway St, Dermott, AR 71638 Phone: 870-538-3355 Fax: 855-811-4203 | |
Mainline Health Systems, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 134 South Strickland St, Dermott, AR 71638 Phone: 870-538-5414 Fax: 870-538-5412 | |
Dermott Family Practice, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 N Freeman St, Dermott, AR 71638 Phone: 870-538-3800 |