# PASSPORT HEALTH HOLDINGS, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PPH Ohio, LLC.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477970192
- **Authorized official:** DOUG SHACKELL (DIRECTOR OF FINANCE)
- **Authorized official phone:** (480) 646-9024

## Contact information

- **Practice address:** 29 PLANTATION PARK DR, B100 \#117, BLUFFTON, SC 29910
- **Practice address phone:** (888) 909-6551
- **Practice address fax:** (480) 383-6567
- **Mailing address:** 8324 E HARTFORD DR, \#200, SCOTTSDALE, AZ 85255
- **Mailing address phone:** (888) 909-6551
- **Mailing address fax:** (480) 383-6567

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | OH | Yes |

## Other

- **Enumeration date:** 03/19/2014
- **Last updated:** 03/18/2016