Healthcare Provider Details

I. General information

NPI: 1952246639
Provider Name (Legal Business Name): YAVAPAI COUNTY COMMUNITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 WEST PARK AVENUE
ASH FORK AZ
86320
US

IV. Provider business mailing address

1090 COMMERCE DR
PRESCOTT AZ
86305-3700
US

V. Phone/Fax

Practice location:
  • Phone: 928-583-1000
  • Fax:
Mailing address:
  • Phone: 928-583-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: LESLIE ROBIN HORTON
Title or Position: DIRECTOR
Credential:
Phone: 928-442-5303