Provider Demographics
NPI:1154315232
Name:CHAMMAS, LLC
Entity Type:Organization
Organization Name:CHAMMAS, LLC
Other - Org Name:NEB DOCTORS OF OH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-588-9630
Mailing Address - Street 1:PO BOX 922189
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30010-2189
Mailing Address - Country:US
Mailing Address - Phone:888-588-9630
Mailing Address - Fax:888-835-3354
Practice Address - Street 1:6779 ENGLE RD BLDG 2
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-7952
Practice Address - Country:US
Practice Address - Phone:216-227-8093
Practice Address - Fax:888-835-3354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2532745Medicaid
OH2532745Medicaid