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CH06273N MAINLINE HEALTH SYSTEMS INC (Active)
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Main Details
Name
MAINLINE HEALTH SYSTEMS INC
Subdivision Name
Star City High School Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-037716
340B ID
CH06273N
Grant Number
H80CS00638
Additional Details
Current Program Status
Active
Registration Date
10/9/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/23/2017
Last Recertification Date
2/24/2025
Contacts
Authorizing Official
Mainline Health Systems
GARY ALLAN NICHOLS, Executive Director
(870) 538-5414
Primary Contact
Mainline Health Systems
Courtney Keller, PharmD
(870) 538-5414
Addresses
Street Address
400 E Arkansas St RM E3
Star City, AR 71667-4821
Billing Address
Mainline Health Systems Inc
342 Hwy 425 S
Monticello, AR 71655
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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