NPIMap

Organization Active NPI

Molled Travel Vaccines, PLLC

Doing business as Passport Health

  • Public Health & General Preventive Medicine Physician
  • Glendale, AZ
National Provider Identifier
1275074700
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
Legal business name
MOLLED TRAVEL VACCINES, PLLC
Doing business as
Passport Health
Practice address
18001 N 79TH Ave
Suite a-14
Glendale, AZ 85308-8388
Phone
(877) 358-8648
Fax
(877) 877-6875
NPI assigned
Mar 16, 2017
Last updated
Aug 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Paul Fishburn
Title
Chief Operating Officer
Phone
(480) 646-9020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X Primary

Addresses

Primary practice location

18001 N 79TH Ave
Suite a-14
Glendale, AZ 85308-8388

Mailing address

668 N 44TH St
Suite 100W
Phoenix, AZ 85008-6507
Phone (877) 358-8648

Other names 2

  • Passport Health Doing business as
  • PPH Franchise Holdings, LLC Other name

National Provider Directory

National Provider Directory
Tax ID family
Passport Health Holdings LLC219 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

18001 N 79th Ave
Ste A14
Glendale, AZ 85308

18301 N 79th Ave
Ste D148
Glendale, AZ 85308

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1275074700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 N 44TH ST",
            "address_2": "SUITE 100W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086507",
            "telephone_number": "877-358-8648",
            "fax_number": "480-546-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE",
            "address_2": "SUITE A-14",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088388",
            "telephone_number": "877-358-8648",
            "fax_number": "877-877-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLLED TRAVEL VACCINES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-16",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "FISHBURN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "480-646-9020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Passport Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PPH Franchise Holdings, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.