| Name: | Champion Medical Systems, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 31 Aug 2010 (14 years ago) |
| Date of dissolution: | 16 Aug 2017 |
| Entity Number: | 000-301-339 |
| Register Number: | 000301339 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | ---BIRMINGHAM, AL |
| Registered Office Street Address: | 1220 16TH ST SOUTHBIRMINGHAM, AL 35205 |
| Registered Office Street Address ZIP Code: | 35205 |
Activities
MEDICAL EQUIPMENT SUPPLIES/HEALTH CARE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588953798 | 2011-03-29 | 2011-03-29 | 1220 16TH ST S, SUITE 100, BIRMINGHAM, AL, 352054716, US | 1220 16TH ST S, SUITE 100, BIRMINGHAM, AL, 352054716, US | |||||||||||||||||||||||||
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| Phone | +1 205-588-6111 |
| Fax | 2055888113 |
Authorized person
| Name | MR. TONY HUBERT NZERIBE |
| Role | MANAGING DIRECTOR |
| Phone | 2055886111 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 201269 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CITY OF BIRMINGHAM BUSINESS LICENSE |
| Number | 201269 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| IFEDIBA, ANTHONY | Member | 1220 16TH STREET SOUTHBIRMINGHAM, AL 35205 |
| NZERIBE, TONY H | Member | 1220 16TH STREET SOUTH SUITE 100BIRMINGHAM, AL 35205 |
| HARRIS, LINDSEY | Member | 1220 16TH STREET SOUTH SUITE 100BIRMINGHAM, AL 35205 |
| Name | Role | Address |
|---|---|---|
| IFEDIBA, ANTHONY | Agent | 1220 16TH STREET SOUTHBIRMINGHAM, AL 35205 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
