Organization
PASSPORT HEALTH HOLDINGS, LLC
Active
Other names
Passport Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL FISHBURN (CHIEF OPERATING OFFICER)
(480) 646-9020
Entity
Organization
Contact information
Practice address
37 VILLA ROAD, SUITE 301, GREENVILLE, SC 29615-3038
(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
261Q00000X
Clinic/Center
Primary
—
SC
Other
Enumeration date
03/19/2014
Last updated
04/01/2022
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