Organization
PASSPORT HEALTH HOLDINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUG SHACKELL (DIRECTOR OF FINANCE)
(480) 646-9024
Entity
Organization
Contact information
Practice address
8324 E HARTFORD DR, SUITE 200, SCOTTSDALE, AZ 85255-5466
(877) 358-8648
(877) 877-6875
Mailing address
8324 E HARTFORD DR, SUITE 200, SCOTTSDALE, AZ 85255-5466
(877) 358-8648
(877) 877-6875
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/30/2014
Last updated
04/20/2016
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