| Passport Health | |
|
2154 N Center St Suite A104 North Charleston SC 29406-4056 | |
| (843) 225-5688 | |
| (843) 225-5689 |
| Full Name | Passport Health |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 2154 N Center St, North Charleston, South Carolina |
| Authorized Official Name and Position | Adam Taylor (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8432255688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passport Health 2154 N Center St Suite A104 North Charleston SC 29406-4056 Ph: (843) 225-5688 | Passport Health 2154 N Center St Suite A104 North Charleston SC 29406-4056 Ph: (843) 225-5688 |
| NPI Number | 1376890152 |
|---|---|
| Provider Enumeration Date | 08/10/2012 |
| Last Update Date | 08/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376890152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | MD7722 (South Carolina) | Primary |
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