Tri State Primary Care

LBN: Colorado River Primary Care, Inc
Tri State Primary Care is an health care organization with primary practice located at 1510 E Wagon Wheel Ln Ste 104 , Fort Mohave AZ 86426-6698. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Ambulatory Health Care Facilities / Primary Care. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Colorado River Primary Care, Inc can be contacted via phone (928) 248-0518, or through Cooper, Wantzy via phone (928) 248-0518.

Contact Information

Primary practice address
1510 E Wagon Wheel Ln Ste 104 Fort Mohave AZ 86426-6698
Phone: (928) 248-0518
Fax: (928) 514-2823
Website:
Map and Directions
Authorized official contact:
Name: Cooper, Wantzy Doctor of Osteopathy (DO)
Phone: (928) 248-0518

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1669146536
LBN Legal business name Colorado River Primary Care, Inc
DBA Doing business as Tri State Primary Care
Authorized official Cooper, Wantzy Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 4th, 2021
Last updated Mar 4th, 2024 - about 6 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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