Organization
CHAMPION EMS
Active
Organization
CHAMPION EMS
Active
Other names
CHRISTUS EMS
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN SALTER (CAO)
(903) 291-2600
Entity
Organization
Contact information
Practice address
2201 S MOBBERLY AVE, LONGVIEW, TX 75602-3565
(903) 291-2600
(903) 291-2632
Mailing address
2201 S MOBBERLY AVE, LONGVIEW, TX 75602-3565
(903) 291-2600
(903) 291-2632
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
300228
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000712201
—
TX
01
—
AMB528
BCBS PROVIDER NUMBER
TX
Enumeration date
10/02/2006
Last updated
07/13/2021
Update your record
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