Organization · Type 2 NPI

Passport Health Holdings LLC

Clinic/Center · North Charleston, SC

NPI number 1588094585 Active

Practice location

2154 North Center Street, Suite A-104
North Charleston, SC 29406-4056

Call (877) 358-8648 Map

Fax (877) 877-6875

Mailing address

668 N 44th St, Suite 100W
Phoenix, AZ 85008-6507

Specialties and licenses

Taxonomy	Code	License
Public Health & General Preventive Medicine Physician	2083P0901X	None listed
Clinic/Center	261Q00000X	None listed
Clinic/Center Primary	261Q00000X	None listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Other clinic/center providers in North Charleston

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NPI record

NPI: 1588094585
Entity type: Organization (Type 2)
Issued: Nov 13, 2013
Last updated: Apr 1, 2022
Status: Active

Other names

<unavail>
PPH Ohio LLC · former legal business name
PPH Ohio LLC · former legal business name

Authorized official

Mr. Paul Fishburn
Chief Operating Officer
(480) 646-9020

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1588094585

Passport Health Holdings LLC's National Provider Identifier is 1588094585, issued on Nov 13, 2013. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in North Charleston, SC. The record was last updated on Apr 1, 2022.