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CH06273S MAINLINE HEALTH SYSTEMS INC (Active)
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Main Details
Name
MAINLINE HEALTH SYSTEMS INC
Subdivision Name
Mainline Rison
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027076
340B ID
CH06273S
Grant Number
H80CS00638
Additional Details
Current Program Status
Active
Registration Date
1/7/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/14/2019
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
505 Sycamore St.
Rison, AR 71665
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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