Healthcare Provider Details

I. General information

NPI: 1922942861
Provider Name (Legal Business Name): GOLDMINE JV NON EMERGENCY TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1182 W VINEYARD PLAINS DR
SAN TAN VLY AZ
85143-3470
US

IV. Provider business mailing address

1182 W VINEYARD PLAINS DR
SAN TAN VLY AZ
85143-3470
US

V. Phone/Fax

Practice location:
  • Phone: 602-487-8998
  • Fax: 480-531-9529
Mailing address:
  • Phone: 602-487-8998
  • Fax: 480-531-9529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: JAMES VERDIEU
Title or Position: MANAGER
Credential: VERDIEU
Phone: 602-487-8998