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General NPI Number Information
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NPI Number | 1881956548
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Entity Type | Organization
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Legal Business Name | CHAMPION HOME CARE LLC
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 5980 OLD GREENSBORO RD STE C
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City | TUSCALOOSA
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State | AL
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Zip | 35405-6226
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Country | US
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Telephone | 205-556-9760
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Fax | 205-553-2150
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Provider Business Mailing Address
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Address Line | 5980 OLD GREENSBORO RD STE C
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City | TUSCALOOSA
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State | AL
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Zip | 35405-6226
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Country | US
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Telephone | 205-556-9760
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Fax | 205-553-2150
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Authorized Official
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Title or Position | OWNER
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Name | BRADLEY DAVID CHAMPION
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Credential |
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Telephone | 205-799-1084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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