Healthcare Provider Details

I. General information

NPI: 1235043670
Provider Name (Legal Business Name): OZARK TAILORED INDEPENDENCE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20212 SONORA RD APT Q
SPRINGDALE AR
72764-6898
US

IV. Provider business mailing address

20212 SONORA RD APT Q
SPRINGDALE AR
72764-6898
US

V. Phone/Fax

Practice location:
  • Phone: 479-545-1252
  • Fax:
Mailing address:
  • Phone: 479-545-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHAD QUAYLE
Title or Position: OWNER
Credential:
Phone: 479-545-1252