Individual ProviderLogan HolmanPediatricsAllopathic & Osteopathic PhysiciansPractice Address1601 Center St, Mobile, AL 36604-1541(251) 410-5437(251) 434-3626PECOS EnrollmentBased on the most recent information from CMS, provider Logan Holman is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 11:36 AM.Profile DetailsProvider ID1821593393Provider TypeIndividualFull NameHolman, LoganGenderMaleSole ProprietorNoEnumeration Date3/27/2018Last Updated12/28/2021Contact InformationPractice LocationPractice Address1601 Center St, Mobile, AL 36604-1541Phone(251) 410-5437Fax(251) 434-3802Mailing LocationMailing AddressPO Box 746450, Atlanta, GA 30374-6450Phone(251) 434-3626Fax(251) 445-2464Provider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseDO.2179Alabama