PASSPORT HEALTH NPI 1205255247

NPI Information

  • NPI: 1205255247
  • Provider Name: PASSPORT HEALTH
  • Classification: Clinic/Center - 261QH0100X
  • Specialization: Health Service
  • Entity Type: Organization
  • Address: 2025 S BRENTWOOD BLVD
    SUITE 101
    SAINT LOUIS, MO
    ZIP 63144
  • Phone: (314) 997-8100

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NPI Details

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 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
1261QH0100XClinic/CenterHealth ServiceYes

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: 11/21/2025

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