Organization
GOLDEN HEART TRANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS JAVIER VILLICANA TAPIA (OWNER/PRESIDDENT)
(623) 606-1907
Entity
Organization
Contact information
Practice address
11939 W COLUMBINE DR, EL MIRAGE, AZ 85335-3369
(623) 476-2243
(623) 476-5646
Mailing address
11939 W COLUMBINE DR, EL MIRAGE, AZ 85335-3369
(623) 476-2243
(623) 476-5646
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
D02901838
AZ
Other
Enumeration date
08/06/2016
Last updated
08/06/2016
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