Healthcare Provider Details

I. General information

NPI: 1609010511
Provider Name (Legal Business Name): MOHAVE COUNTY DEPT. OF PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2009
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2096 S HWY 389
COLORADO CITY AZ
86021-6037
US

IV. Provider business mailing address

700 W BEALE ST
KINGMAN AZ
86401-5711
US

V. Phone/Fax

Practice location:
  • Phone: 928-753-8675
  • Fax: 928-875-8961
Mailing address:
  • Phone: 928-753-0714
  • Fax: 928-753-0775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberOTC3466
License Number StateAZ

VIII. Authorized Official

Name: MRS. MELISSA PALMER
Title or Position: HEALTH DIRECTOR
Credential: M.ADM, BS, MCHES
Phone: 928-753-0748