CHAMPION EMS NPI 1265087779

NPI Information

NPI: 1265087779
Provider Name: CHAMPION EMS
Classification: Emergency Medical Technician, Intermediate - 146M00000X
Entity Type: Organization

CLIA Number: 11D2266312

Address:
6722 HIGHWAY 85 STE 5
RIVERDALE, GA
ZIP 30274
Phone: (770) 744-9157
Get Directions

CHAMPION EMS is an emergency medical technician intermediate in Riverdale, GA. The provider is an Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. CHAMPION EMS NPI is 1265087779. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6722 HIGHWAY 85 STE 5
RIVERDALE, GA
ZIP 30274-373
Phone: (770) 744-9157

The provider's authorized official is Arelious Dunn .
The authorized official title is Owner and has the following contact phone number (770) 744-9157.

The CLIA number assigned to this NPI record is 11D2266312 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/2/2019 and was last updated on 8/2/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	146M00000X	Emergency Medical Technician, Intermediate				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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