Provider Demographics
NPI:1407985005
Name:THE MEDI SELL CORP
Entity Type:Organization
Organization Name:THE MEDI SELL CORP
Other - Org Name:ELECTRO MED SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:TITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:COF
Authorized Official - Phone:502-459-6603
Mailing Address - Street 1:PO BOX 18366
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40261-0366
Mailing Address - Country:US
Mailing Address - Phone:502-459-6603
Mailing Address - Fax:502-459-6604
Practice Address - Street 1:4400 BISHOP LANE
Practice Address - Street 2:SUITE 202
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218
Practice Address - Country:US
Practice Address - Phone:502-459-6603
Practice Address - Fax:502-459-6604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1063090Medicaid
KY1063090Medicaid