Mainline Dermott Dental Clinic
LBN: Mainline Health Systems, Inc
Mainline Dermott Dental Clinic is an health care organization with primary practice located at 300 S School St , Dermott AR 71638-2127. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Dental, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty.
Mainline Health Systems, Inc can be contacted via phone (870) 538-9720, or through Nichols, Gary Allan via phone (870) 942-3000.
Contact Information
Primary practice address
300 S School St
Dermott AR 71638-2127
Phone: (870) 538-9720
Fax: (870) 538-9701
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Dental | 261QD0000X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X |
Profile Details
| NPI number | 1417064890 |
|---|---|
| LBN Legal business name | Mainline Health Systems, Inc |
| DBA Doing business as | Mainline Dermott Dental Clinic |
| Authorized official | Nichols, Gary Allan |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 23rd, 2006 |
| Last updated | Jul 10th, 2024 - about 4 months ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417064890 | NPPES |
| Arkansas | MEDICAID | 152991631 |
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