Provider Demographics
NPI:1346325412
Name:MEDLOGIC CPAP INC.
Entity Type:Organization
Organization Name:MEDLOGIC CPAP INC.
Other - Org Name:MEDLOGIC CPAP INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WAITES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-358-7500
Mailing Address - Street 1:433 SAINT LUKES DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7107
Mailing Address - Country:US
Mailing Address - Phone:334-396-8082
Mailing Address - Fax:334-396-8084
Practice Address - Street 1:433 SAINT LUKES DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7107
Practice Address - Country:US
Practice Address - Phone:334-396-8082
Practice Address - Fax:334-396-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QS1200X
MS04809332BX2000X
AL900898332BX2000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1301950001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO MS
MS00440649Medicaid