PASSPORT HEALTH HOLDINGS LLC


Address: 1402 Shepard Dr, Ste 101, Sterling, VA 20164-4425
Phone: 8773588648

PASSPORT HEALTH HOLDINGS LLC (NPI# 1336579226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336579226
Entity Type Organization
Organization Name PASSPORT HEALTH HOLDINGS LLC
Other Organization Name PPH GLOBAL SERVICES LLC
Practice Address 1402 Shepard Dr
Ste 101
Sterling
VA 20164-4425
Mailing Address 8324 E Hartford Dr
Ste 200
Scottsdale
AZ 85255-5466
Practice Telephone 8773588648
Practice Fax Number 8778776875
Mailing Telephone 8773588648
Mailing Fax Number 8778776875
Enumeration Date 2013-11-14
Last Update Date 2016-07-11
Authorized Official Name MR. DOUG SHACKELL (DIRECTOR OF FINANCE)
Authorized Official Telephone 4806469024
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261Q00000X Clinic/Center VA Ambulatory Health Care Facilities
N 2083P0901X Preventive Medicine
Specialization: Public Health & General Preventive Medicine
Allopathic & Osteopathic Physicians
Y 261Q00000X Clinic/Center Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
PPH Global Services LLC Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1376033233 Passport Health Holdings LLC Preventive Medicine 4647 N 32nd Street, Suite 115 1st Floor, Phoenix, AZ 85018-3346 2018-05-16
1275988891 Passport Health Holdings LLC Preventive Medicine 315 W Ponce De Leon Ave Ste 585, Decatur, GA 30030-2400 2016-05-02
1598195489 Passport Health Holdings LLC Clinic/Center 5890 Sawmill Rd, Suite 100, Dublin, OH 43017-1591 2013-11-14
1669802559 Passport Health Holdings LLC Preventive Medicine 260 W Coleman Blvd, Ste B, Mt Pleasant, SC 29464-3666 2013-11-14
1518397405 Passport Health Holdings LLC Preventive Medicine 400 N Center Drive, Suite 108, Norfolk, VA 23502-0002 2013-11-14
1245660133 Passport Health Holdings LLC Clinic/Center 512 Westwood Office Park, Fredricksburg, VA 22401-5112 2013-11-14
1609206564 Passport Health Holdings LLC Preventive Medicine 2318-b Sunset Blvd, West Columbia, SC 29169-4716 2013-11-13
1043640048 Passport Health Holdings LLC Preventive Medicine 3691 Palmetto Point Blvd, Ste 301, Myrtle Beach, SC 29588-1202 2013-11-13
1003245291 Passport Health Holdings LLC Preventive Medicine 6355 Nw 36th St Ste 600, Virginia Gardens, FL 33166-7027 2013-11-07
1407189392 Passport Health Holdings LLC Preventive Medicine 8249 W 95th St, Ste 105, Overland Park, KS 66212-3200 2009-09-10

Office Location

Street Address 1402 SHEPARD DR
STE 101
City STERLING
State VA
Zip Code 20164-4425

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1962905323 Grace A Oluwadiya Registered Nurse 21335 Signal Hill Plaza, Suite 270, Sterling, VA 20164 2018-03-13
1922468602 Harris Teeter LLC Durable Medical Equipment & Medical Supplies 21399 Epicerie Plaza, Sterling, VA 20164 2016-02-24
1942625603 Totalmobility LLC Durable Medical Equipment & Medical Supplies 201 Davis Drive, Suite Nn, Sterling, VA 20164 2014-03-04
1346689189 Traci Collier Pharmacist 22375 Davis Dr, Sterling, VA 20164 2013-06-14
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1750676789 Sheikh M Rasul Pharmacist 20600 Great Falls Plaza, Sterling, VA 20164 2011-06-17
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1336517044 Rediclinic of Va, LLC Clinic/Center 20800 Great Falls Plaza, Sterling, VA 20165-2464 2015-09-11
1700040367 Zina Alathari, Dmd PC Clinic/Center 21155 Whitfield Pl Ste 106, Sterling, VA 20165-7277 2008-07-14
1356526040 Partners In Health of Sterling Clinic/Center 2605 Woodlawn Rd, Suite 3, Sterling, IL 61081-4174 2008-01-01
1215142484 Tlc Whitten Laser Eye Care, LLC Clinic/Center 46169 Westlake Dr, Ste. 240, Sterling, VA 20165-5875 2007-05-11
1942238555 Sterling Regional Medcenter Clinic/Center 615 Fairhurst St, Sterling, CO 80751-4523 2006-06-30

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1417579889 Health Bridge, LLC Clinic/Center 4198 Cox Rd Ste 102, Glen Allen, VA 23060-3328 2020-05-08
1851924088 First Light Clinic LLC Clinic/Center 706 Campbell Ave Sw, Roanoke, VA 24016-3534 2020-02-17
1912537440 B's Integrated Clinic, Pllc Clinic/Center 501 Rison St Ste 100, Danville, VA 24541-2426 2020-01-23
1770122723 Colonial Beach Health & Wellness Inc Clinic/Center 700 Mckinney Blvd Ste 1100, Colonial Beach, VA 22443-1934 2019-12-21
1104461896 Lung Specialists of Tidewater Pllc Clinic/Center 224 Avonlea Pointe, Chesapeake, VA 23322-4279 2019-11-17
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Competitor

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City STERLING
Zip Code 20164

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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