Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Passport Health Holdings LLC

Organization Public Health & General Preventive Medicine Physician · NPI 1043640048

Passport Health Holdings LLC provides Public Health & General Preventive Medicine Physician services in Myrtle Beach, South Carolina. Licensed in South Carolina. Registered with an NPI since 2013.

Licensed in
SC
In the registry since
2013
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3691 Palmetto Point Blvd Ste 301
Myrtle Beach, SC 29588-1202
Phone: (877) 358-8648
Fax: (877) 877-6875
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X (SC)
Public Health & General Preventive Medicine Physician Taxonomy 2083P0901X

Record details

NPI number1043640048
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Fishburn — Chief Operating Officer · (480) 646-9020
Other names Pph Ohio Llc; Pph Ohio Llc
NPI enumeratedNovember 13, 2013
Last updated in NPPESApril 1, 2022
Certification dateApril 1, 2022
Mailing address668 N 44th St, Suite 100w, Phoenix, AZ 85008-6507

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