Provider Demographics
NPI:1801493937
Name:CHAMPION NURSING SERVICES, INC
Entity type:Organization
Organization Name:CHAMPION NURSING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KETHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-719-0631
Mailing Address - Street 1:2365 WALL ST SE STE 230
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2197
Mailing Address - Country:US
Mailing Address - Phone:404-587-0945
Mailing Address - Fax:678-658-7634
Practice Address - Street 1:2365 WALL ST SE STE 210
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2197
Practice Address - Country:US
Practice Address - Phone:404-719-0631
Practice Address - Fax:678-658-7634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based