# PASSPORT HEALTH HOLDINGS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Passport Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619394335
- **Authorized official:** MR. PAUL FISHBURN (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (480) 646-9020

## Contact information

- **Practice address:** 37 VILLA ROAD, SUITE 301, GREENVILLE, SC 29615-3038
- **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 |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | SC | Yes |

## Other

- **Enumeration date:** 03/19/2014
- **Last updated:** 04/01/2022