Organization
CHAMPION HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRYL CHAMPION (ADMINISTRATOR)
(615) 554-7401
Entity
Organization
Contact information
Practice address
528 W MAIN ST, LEBANON, TN 37087-3403
(615) 554-7401
(615) 807-3303
Mailing address
528 W MAIN ST, LEBANON, TN 37087-3403
(615) 554-7401
(615) 807-3303
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/06/2014
Last updated
04/22/2016
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