Healthcare Provider Details

I. General information

NPI: 1003741919
Provider Name (Legal Business Name): VIACARE TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6622 N 59TH DR
GLENDALE AZ
85301-3804
US

IV. Provider business mailing address

6622 N 59TH DR
GLENDALE AZ
85301-3804
US

V. Phone/Fax

Practice location:
  • Phone: 602-727-9217
  • Fax:
Mailing address:
  • Phone: 602-727-9217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DAVID GAMA
Title or Position: OWNER/DRIVER
Credential:
Phone: 602-727-9217