Ob Lake Village

LBN: Mainline Health Systems, Inc
Ob Lake Village is an health care organization with primary practice located at 2729 Us 65 , Lake Village AR 71653. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Mainline Health Systems, Inc can be contacted via phone (870) 466-4987, or through Nichols, Gary Allan via phone (870) 942-3000.

Contact Information

Primary practice address
2729 Us 65 Lake Village AR 71653
Phone: (870) 466-4987
Fax: (855) 926-7383
Website:
Map and Directions
Authorized official contact:
Name: Nichols, Gary Allan
Phone: (870) 942-3000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1548949852
LBN Legal business name Mainline Health Systems, Inc
DBA Doing business as Ob Lake Village
Authorized official Nichols, Gary Allan
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2023
Last updated Jul 11th, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548949852 NPPES
Arkansas MEDICAID 315451749

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