MEDICARE: CHAMPION PALOMITA SERVICES INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1548692049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMPION PALOMITA SERVICES INC

Provider Business Mailing Address
First Line	:	1419 MARKET ST
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78040-8841
Country	:	US
Telephone Number	:	956-857-7086
Fax Number	:	956-583-4621

Provider Business Practice Location Address
First Line	:	116 MICHOACAN LOOP
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-6633
Country	:	US
Telephone Number	:	956-857-7086
Fax Number	:	956-583-4621

Authorized Official
Title or Position	:	SUPERVISOR
Name	:	EFRAIN EDUARDO GUTIERREZ
Credential	:
Telephone Number	:	956-400-8810

Provider Enumeration Date	:	08/07/2013
Last Update Date	:	06/26/2026

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Directions to “CHAMPION PALOMITA SERVICES INC ” Practice Location

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