Provider Demographics
NPI:1275172603
Name:BLACKSTAR LOGISTICS TRANSPORATION LLC
Entity Type:Organization
Organization Name:BLACKSTAR LOGISTICS TRANSPORATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-208-0325
Mailing Address - Street 1:16323 QUAIL ECHO DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-5321
Mailing Address - Country:US
Mailing Address - Phone:713-208-0325
Mailing Address - Fax:
Practice Address - Street 1:16323 QUAIL ECHO DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-5321
Practice Address - Country:US
Practice Address - Phone:713-208-0325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLACKSTAR ELITE CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty