Provider Demographics
NPI:1326083296
Name:CHAMPION MEDICAL SERVICES
Entity Type:Organization
Organization Name:CHAMPION MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:LIVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-588-2848
Mailing Address - Street 1:PO BOX 50289
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30302-0289
Mailing Address - Country:US
Mailing Address - Phone:404-588-2848
Mailing Address - Fax:
Practice Address - Street 1:505 PRYOR ST SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-2717
Practice Address - Country:US
Practice Address - Phone:404-588-2848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies