Provider Demographics
NPI:1891715702
Name:CHAMPION MEDICAL EQUIPMENT RENTAL &SALES LLC
Entity Type:Organization
Organization Name:CHAMPION MEDICAL EQUIPMENT RENTAL &SALES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:EDGECOMBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-229-1112
Mailing Address - Street 1:324 LONG AVE PORT ST
Mailing Address - Street 2:
Mailing Address - City:JOE
Mailing Address - State:FL
Mailing Address - Zip Code:32456
Mailing Address - Country:US
Mailing Address - Phone:850-229-1112
Mailing Address - Fax:850-229-1112
Practice Address - Street 1:324 LONG AVE PORT ST
Practice Address - Street 2:
Practice Address - City:JOE
Practice Address - State:FL
Practice Address - Zip Code:32456
Practice Address - Country:US
Practice Address - Phone:850-229-1112
Practice Address - Fax:850-229-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies