Organization
PASSPORT HEALTH OHIO LLC
Active
Other names
Passport Health
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI SOWARDS (CLINICAL RN SUPERVIS)
(888) 909-6551
Entity
Organization
Contact information
Practice address
38 BOLAND CT, GREENVILLE, SC 29615
(888) 909-6551
(480) 383-6567
Mailing address
6710 E CAMELBACK RD, SCOTTSDALE, AZ 85251
(888) 909-6551
(480) 383-6567
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
SC
Other
Enumeration date
11/14/2013
Last updated
11/14/2013
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