Provider Demographics
NPI:1205196516
Name:MID-AMERICA ELEVATOR CO., INC.
Entity Type:Organization
Organization Name:MID-AMERICA ELEVATOR CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SELKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-635-5500
Mailing Address - Street 1:1116 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-3829
Mailing Address - Country:US
Mailing Address - Phone:317-635-5500
Mailing Address - Fax:317-635-3392
Practice Address - Street 1:1116 E MARKET ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-3829
Practice Address - Country:US
Practice Address - Phone:317-635-5500
Practice Address - Fax:317-635-3392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCO10987332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment