Champion Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CHAMPION MEDICAL SUPPLY

Practice address

1996 Glentana St
Simi Valley, CA 93065-0553

Phone

(310) 462-1944

Fax

(805) 582-9873

NPI assigned

Jan 28, 2008

Last updated

Jan 28, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jerome Kevin Tyler

Title

Owner

Phone

(310) 462-1944

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1437336955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1996 GLENTANA STREET",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "93065",
            "telephone_number": "310-462-1944",
            "fax_number": "805-582-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1996 GLENTANA ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930650553",
            "telephone_number": "310-462-1944",
            "fax_number": "805-582-9873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-462-1944",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cep America - Neurology PC
• Brittany Cervantes, NP
• Steven Cha, M.D.
• Chad Wilde MD, a Medical Corporation (Simi Pain Center)
• Rajeswari Challa, DDS
• Reyna Chang
• Edward A Chapin, DDS
• Catherine L Chapman
• Charter Hospice, LLC.
• Bianca Francesca Chavez

• Durable Medical Equipment & Medical Supplies in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.