Organization
MAINLINE HEALTH SYSTEMS, INC
Active
Other names
Portland Elementary Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ALLAN NICHOLS (CEO)
(870) 942-3000
Entity
Organization
Contact information
Practice address
314 HIGHWAY 160 E, PORTLAND, AR 71663-9262
(870) 726-4085
(855) 878-5991
Mailing address
342 HIGHWAY 425 S, MONTICELLO, AR 71655-4612
(870) 942-3000
(870) 942-3005
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214420749
—
AR
Enumeration date
12/31/2015
Last updated
03/20/2026
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