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General NPI Number Information
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NPI Number | 1376097980
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Entity Type | Organization
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Legal Business Name | PASSPORT HEALTH
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Dates
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Enumeration Date | 08/11/2016
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 890 MILL ST STE 301
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City | RENO
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State | NV
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Zip | 89502-1436
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Country | US
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Telephone | 888-909-6551
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Fax | 877-877-6875
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Provider Business Mailing Address
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Address Line | 890 MILL ST STE 301
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City | RENO
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State | NV
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Zip | 89502-1436
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Country | US
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Telephone | 888-909-6551
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Fax | 877-877-6875
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Authorized Official
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Title or Position | VP CLINIC OPERATIONS
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Name | MELANIE FRENCH
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Credential |
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Telephone | 888-909-6551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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