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General NPI Number Information
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NPI Number | 1225617129
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Entity Type | Organization
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Legal Business Name | CHAMPION ANGEL'S HOMECARE
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 4464 DEVINE ST
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City | COLUMBIA
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State | SC
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Zip | 29205-3605
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Country | US
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Telephone | 803-470-6388
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Fax |
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Provider Business Mailing Address
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Address Line | 214 GRAHAM ST # A
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City | SALUDA
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State | SC
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Zip | 29138-1570
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Country | US
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Telephone | 864-323-4496
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TEMPESTT MYERS
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Credential |
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Telephone | 864-323-4496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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