Provider Demographics
NPI:1861745200
Name:EDUMEDICS, LLC
Entity type:Organization
Organization Name:EDUMEDICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CISSELL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:502-569-1044
Mailing Address - Street 1:201 E JEFFERSON ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1246
Mailing Address - Country:US
Mailing Address - Phone:502-569-1044
Mailing Address - Fax:502-569-0309
Practice Address - Street 1:201 E JEFFERSON ST
Practice Address - Street 2:SUITE 301
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1246
Practice Address - Country:US
Practice Address - Phone:502-569-1044
Practice Address - Fax:502-569-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care