Organization Name: | MAINLINE HEALTH SYSTEMS INC |
NPI Number: | 1891809547 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY A SCOTT (CFO) |
Mailing Address: | 203 Mccomb St Wilmot |
State: | AR US |
Postal Code: | 71676 |
Phone Number: | 8704732274 |
Fax Number: | 8704735392 |
NPI Enumeration Date: | 08/19/2006 |
NPI Last Update Date: | 05/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |