Healthcare Provider Details

I. General information

NPI: 1891573523
Provider Name (Legal Business Name): OZARK HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2023
Last Update Date: 09/14/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 SCHOOL DR
SHIRLEY AR
72153-7566
US

IV. Provider business mailing address

PO BOX 206
CLINTON AR
72031-0206
US

V. Phone/Fax

Practice location:
  • Phone: 501-723-4400
  • Fax: 501-745-9741
Mailing address:
  • Phone: 501-745-9524
  • Fax: 501-745-9741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REBECCA GENTRY
Title or Position: ACCOUNTING SPECIALIST
Credential:
Phone: 501-745-9524