| Passport Health Ohio Llc | |
|
38 Boland Ct Greenville SC 29615 | |
| (888) 909-6551 | |
| (480) 383-6567 |
| Full Name | Passport Health Ohio Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 38 Boland Ct, Greenville, South Carolina |
| Authorized Official Name and Position | Vicki Sowards (CLINICAL RN SUPERVIS) |
| Authorized Official Contact | 8889096551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passport Health Ohio Llc 6710 E Camelback Rd Scottsdale AZ 85251 Ph: (888) 909-6551 | Passport Health Ohio Llc 38 Boland Ct Greenville SC 29615 Ph: (888) 909-6551 |
| NPI Number | 1396175287 |
|---|---|
| Provider Enumeration Date | 11/14/2013 |
| Last Update Date | 11/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396175287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (South Carolina) | Primary |
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