MEDICARE: MOHAVE COUNTY DEPT OF PUBLIC HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency	OTC3464	AZ

General Provider Information

NPI Number	:	1407090418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOHAVE COUNTY DEPT OF PUBLIC HEALTH

Provider Business Mailing Address
First Line	:	700 W BEALE ST
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86401-5711
Country	:	US
Telephone Number	:	928-753-0714
Fax Number	:	928-753-0775

Provider Business Practice Location Address
First Line	:	1222 HANCOCK RD
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-5906
Country	:	US
Telephone Number	:	928-758-0703
Fax Number	:	928-758-0719

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

Provider Enumeration Date	:	04/22/2009
Last Update Date	:	11/06/2025

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