# PASSPORT HEALTH HOLDINGS LLC

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

## Provider details

- **NPI number:** 1588094585
- **Authorized official:** MR. PAUL FISHBURN (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (480) 646-9020

## Contact information

- **Practice address:** 2154 NORTH CENTER STREET, SUITE A-104, NORTH CHARLESTON, SC 29406-4056
- **Practice address phone:** (877) 358-8648
- **Practice address fax:** (877) 877-6875
- **Mailing address:** 668 N 44TH ST, SUITE 100W, PHOENIX, AZ 85008-6507
- **Mailing address phone:** (877) 358-8648
- **Mailing address fax:** (877) 877-6875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 261Q00000X | Clinic/Center | — | SC | — |

## Other

- **Enumeration date:** 11/13/2013
- **Last updated:** 04/01/2022