Provider Demographics
NPI:1891461166
Name:MEDICAL LOGISTICS LLC
Entity Type:Organization
Organization Name:MEDICAL LOGISTICS LLC
Other - Org Name:MED LOGISTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:GRAYER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:662-346-3883
Mailing Address - Street 1:1590 S MILWAUKEE AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3785
Mailing Address - Country:US
Mailing Address - Phone:847-538-0849
Mailing Address - Fax:
Practice Address - Street 1:520 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-2923
Practice Address - Country:US
Practice Address - Phone:662-346-3883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-18
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker