Provider Demographics
NPI:1164938270
Name:TEAM MUSGROVE SPORTS AGENCY DBA ON TIME WITH CARE LOGISTICS
Entity Type:Organization
Organization Name:TEAM MUSGROVE SPORTS AGENCY DBA ON TIME WITH CARE LOGISTICS
Other - Org Name:ON TIME WITH CARE LOGISTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSGROVE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:972-900-3116
Mailing Address - Street 1:PO BOX 132274
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75313-2274
Mailing Address - Country:US
Mailing Address - Phone:972-900-3116
Mailing Address - Fax:972-364-1235
Practice Address - Street 1:3131 MCKINNEY AVE STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2456
Practice Address - Country:US
Practice Address - Phone:972-900-3116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)