Healthcare Provider Details

I. General information

NPI: 1356288856
Provider Name (Legal Business Name): EZ TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 BAYWOOD CT
BENTON AR
72015-4642
US

IV. Provider business mailing address

1300 BAYWOOD CT
BENTON AR
72015-4642
US

V. Phone/Fax

Practice location:
  • Phone: 501-507-7514
  • Fax:
Mailing address:
  • Phone: 501-507-7514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: CAMILLE ROSE EZUGWU
Title or Position: OWNER
Credential:
Phone: 501-507-7514