Provider Demographics
NPI:1245771823
Name:CRH PHYSICIAN PRACTICES, LLC
Entity Type:Organization
Organization Name:CRH PHYSICIAN PRACTICES, LLC
Other - Org Name:CRH HAZELHURST GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:LAVONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-384-1900
Mailing Address - Street 1:1100 WARD STREET EXT W
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-1902
Mailing Address - Country:US
Mailing Address - Phone:912-260-5379
Mailing Address - Fax:912-384-1470
Practice Address - Street 1:11 CROSS ST
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:GA
Practice Address - Zip Code:31539-6427
Practice Address - Country:US
Practice Address - Phone:912-384-2500
Practice Address - Fax:912-383-6788
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COFFEE REGIONAL MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty