Organization
MAINLINE HEALTH SYSTEMS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELYSE KNOBLOCH (CFO)
(870) 538-5414
Entity
Organization
Contact information
Practice address
342 HIGHWAY 425 S, MONTICELLO, AR 71655-4612
(870) 723-4145
(501) 712-1447
Mailing address
PO BOX 509, DERMOTT, AR 71638-0509
(870) 538-5414
(870) 538-5412
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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