| NPI | 1972085587 |
|---|---|
| Doing Business As | PASSPORT HEALTH |
| Entity Type | Organization |
| Authorized Contact | DOUG SHACKELL Director Of Finance 480-646-9024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2019-07-30 |