OrganizationActive
Colorado River Primary Care, Inc
NPI 1669146536 · Internal Medicine Physician · Fort Mohave, AZ
Provider details
- NPI number
- 1669146536
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Wantzy Cooper, President(928) 248-0518
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Practice location
1510 E Wagon Wheel Ln Ste 104
Fort Mohave, AZ 86426-6698
Phone: (928) 248-0518
Fax: (928) 514-2823
Approximate (ZIP-level) locationGet directions
Mailing address
1510 E Wagon Wheel Ln Ste 104
Fort Mohave, AZ 86426-6698
Other names (DBA / former)
- Doing business as
- Tri State Primary Care
Registry dates
- Enumerated
- 2021-08-04
- Last updated
- 2024-03-04
- Certified
- 2024-03-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.