PASSPORT HEALTH NPI 1205255247

NPI Information

NPI: 1205255247
Provider Name: PASSPORT HEALTH
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 26D2188331

Address:
2025 S BRENTWOOD BLVD
SUITE 101
SAINT LOUIS, MO
ZIP 63144
Phone: (314) 997-8100
Get Directions

PASSPORT HEALTH is a health service clinic center in Saint Louis, MO. PASSPORT HEALTH NPI is 1205255247. The provider is registered as an organization entity type.

The provider's business location address is:

2025 S BRENTWOOD BLVD
SUITE 101
SAINT LOUIS, MO
ZIP 63144-833
Phone: (314) 997-8100
Fax: (314) 997-8102

The provider's authorized official is Ltanya Garrison .
The authorized official title is President and has the following contact phone number (314) 997-8100.

The CLIA number assigned to this NPI record is 26D2188331 - other - trave medicine clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/7/2014 and was last updated on 10/2/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »