Provider Demographics
NPI:1134143811
Name:OZARK SYSTEMS MANUFACTURING, LLC
Entity Type:Organization
Organization Name:OZARK SYSTEMS MANUFACTURING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-524-9778
Mailing Address - Street 1:501 NORTH LINCLON ST
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-1710
Mailing Address - Country:US
Mailing Address - Phone:479-524-9778
Mailing Address - Fax:479-524-6913
Practice Address - Street 1:501 NORTH LINCOLN ST
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-1710
Practice Address - Country:US
Practice Address - Phone:479-524-9778
Practice Address - Fax:479-524-6913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2906504001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies