Passport Health Holdings LLC

Organization Public Health & General Preventive Medicine Physician · NPI 1609206564

Passport Health Holdings LLC provides Public Health & General Preventive Medicine Physician services in West Columbia, 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

2318-B Sunset Blvd
West Columbia, SC 29169-4716 Not confirmed with CMS for 10 years — call before visiting
Phone: (877) 358-8648
Fax: (877) 877-6875

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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 number	1609206564
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Doug Shackell — Director Of Finance · (480) 646-9024
Other names	Pph Ohio Llc
NPI enumerated	November 13, 2013
Last updated in NPPES	July 12, 2016
Mailing address	8324 E Hartford Dr, Suite 200, Scottsdale, AZ 85255-5466