Provider Demographics
NPI:1508623976
Name:PASSENGER INC
Entity Type:Organization
Organization Name:PASSENGER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:TAIT
Authorized Official - Suffix:
Authorized Official - Credentials:CPRC
Authorized Official - Phone:313-671-3536
Mailing Address - Street 1:2176 TROWBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-4403
Mailing Address - Country:US
Mailing Address - Phone:313-671-3536
Mailing Address - Fax:
Practice Address - Street 1:2697 CANIFF ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3032
Practice Address - Country:US
Practice Address - Phone:313-288-0062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty