Mainline Health Systems, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Dermott, AR
NPI 1891245809 · NPPES record last updated Mar 20, 2026
Key facts
- NPI
- 1891245809
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- MAINLINE HEALTH SYSTEMS, INC
- Practice address
- 525 E Speedway St
Dermott, AR 71638-2322 - Phone
- (870) 277-2658
- Fax
- (855) 811-4203
- NPI assigned
- Oct 13, 2016
- Organization subpart
- No
Authorized official
- Name
- Gary Allan Nichols
- Title
- Ceo
- Phone
- (870) 942-3000
Corporate family (same tax ID) 33
Practitioners 1
-
Myra Brooke Flemister, APRN
National Provider Directory
- Tax ID family
- Sanyasi R Ganta MD
Locations
400 E Arkansas St
Rm E3
Star City, AR 71667
Phone (650) 419-2810
1012 E Church St
Ste B
Warren, AR 71671
Phone (870) 226-4302
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
525 E Speedway St
Dermott, AR 71638-2322
Mailing address
342 Highway 425 S
Monticello, AR 71655-4612
Phone (870) 942-3000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 217955631 | Medicaid | AR |
Other names
- Dermott School Dental Clinic
Other providers in Dermott, AR
- Elmer Ann Johnson
- Courtney Keller
- Mainline Health Systems Inc
- Mainline Health Systems, Inc
- Mainline Health Systems, Inc
- Marvin D. Loyd, DDS
- Medical Transport Management, Inc
- Medical Transport Management, LLC
- Dana Shea Phillips
- Professional Pharmacy Services Inc
All providers in Dermott, AR · Federally Qualified Health Center (FQHC) in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.