Provider Demographics
NPI:1376670125
Name:MEDICAL LOGISTICS
Entity Type:Organization
Organization Name:MEDICAL LOGISTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-949-7430
Mailing Address - Street 1:1252 MONTE VISTA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-8215
Mailing Address - Country:US
Mailing Address - Phone:909-949-7430
Mailing Address - Fax:909-949-7907
Practice Address - Street 1:1252 MONTE VISTA AVE STE 2
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-8215
Practice Address - Country:US
Practice Address - Phone:909-949-7430
Practice Address - Fax:909-949-7907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
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
CA5338570001Medicare ID - Type UnspecifiedMEDICARE PROVIDER