Healthcare Provider Details

I. General information

NPI: 1346325412
Provider Name (Legal Business Name): MEDLOGIC CPAP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 SAINT LUKES DR
MONTGOMERY AL
36117-7107
US

IV. Provider business mailing address

433 SAINT LUKES DR
MONTGOMERY AL
36117-7107
US

V. Phone/Fax

Practice location:
  • Phone: 334-396-8082
  • Fax: 334-396-8084
Mailing address:
  • Phone: 334-396-8082
  • Fax: 334-396-8084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number04809
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number900898
License Number StateAL

VIII. Authorized Official

Name: MICHAEL WAITES
Title or Position: OWNER
Credential:
Phone: 334-358-7500