Passport Health Holdings, LLC

NPI #1215366406 in Boise, Idaho

Provider Information

NPI Number: 1215366406
Entity Type: Organization
Organization Name: Passport Health Holdings, LLC
Primary Specialty: Clinic/Center
Enumeration Date: Nov 7, 2013
Last Updated: Apr 1, 2022

Practice Location

Address: 910 MAIN ST
Address 2: SUITE 352
City: Boise
State: Idaho
ZIP Code: 83702-5720
Phone: (877) 358-8648

Authorized Official

Name: MR. PAUL FISHBURN
Title: CHIEF OPERATING OFFICER
Phone: (480) 646-9020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Preventive Medicine - Public Health & General Preventive Medicine — Public Health & General Preventive Medicine	2083P0901X
Clinic/Center	261Q00000X	Primary

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