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Organization
PASSPORT HEALTH HOLDINGS LLC
Active
Organization
PASSPORT HEALTH HOLDINGS LLC
Active
Other names
PPH Ohio LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL FISHBURN (CHIEF OPERATING OFFICER)
(480) 646-9020
Entity
Organization
Contact information
Practice address
260 W COLEMAN BOULEVARD, SUITE B, MT PLEASANT, SC 29464-3666
(877) 358-8648
(877) 877-6875
Mailing address
668 N 44TH ST, SUITE 100W, PHOENIX, AZ 85008-6507
(877) 358-8648
(877) 877-6875
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
—
NULL
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
NULL
261Q00000X
Clinic/Center
—
SC
Other
Enumeration date
11/14/2013
Last updated
04/01/2022
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