MEDICARE: OZARK SYSTEMS MANUFACTURING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	2906504001	AR

General Provider Information

NPI Number	:	1134143811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OZARK SYSTEMS MANUFACTURING, LLC

Provider Business Mailing Address
First Line	:	501 NORTH LINCLON ST
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-1710
Country	:	US
Telephone Number	:	479-524-9778
Fax Number	:	479-524-6913

Provider Business Practice Location Address
First Line	:	501 NORTH LINCOLN ST
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-1710
Country	:	US
Telephone Number	:	479-524-9778
Fax Number	:	479-524-6913

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	MR. TOM MARTIN
Credential	:
Telephone Number	:	479-524-9778

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	08/22/2020

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