Passport Health Holdings LLC
Clinic/Center in Mt Pleasant, SC. Organization (NPI-2).
NPI number1669802559
StatusActive
Last updated in NPPESApr 1, 2022
Details
- NPI
- 1669802559
- Entity type
- Organization (NPI-2)
- Legal business name
- Passport Health Holdings LLC
- Organization subpart
- No
- Enumeration date
- Nov 14, 2013
- Certification date
- Apr 1, 2022
- Last updated
- Apr 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 261Q00000X | Clinic/Center | – | SC | |
| 2083P0901X | Preventive Medicine, Public Health & General Preventive Medicine | – | – |
Other names
- Pph Ohio LLC (Former Legal Business Name)
Practice location
260 W Coleman BoulevardSuite B
Mt Pleasant, SC 29464-3666
Phone 877-358-8648 · Fax 877-877-6875
Mailing address
668 N 44th StSuite 100w
Phoenix, AZ 85008-6507
Phone 877-358-8648 · Fax 877-877-6875
Authorized official
Paul Fishburn
Chief Operating Officer
4806469020
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