Organization
COLORADO RIVER PRIMARY CARE, INC
Active
Organization
COLORADO RIVER PRIMARY CARE, INC
Active
Other names
Tri State Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
WANTZY COOPER DO (PRESIDENT)
(928) 248-0518
Entity
Organization
Contact information
Practice address
1510 E WAGON WHEEL LN STE 104, FORT MOHAVE, AZ 86426-6698
(928) 248-0518
(928) 514-2823
Mailing address
1510 E WAGON WHEEL LN STE 104, FORT MOHAVE, AZ 86426-6698
(928) 248-0518
(928) 514-2823
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
08/04/2021
Last updated
03/04/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up