Provider Demographics
NPI:1306359781
Name:CRH PHYSICIAN PRACTICES, LLC
Entity Type:Organization
Organization Name:CRH PHYSICIAN PRACTICES, LLC
Other - Org Name:CRH UROLOGY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF CORPORATE REVENUE CYCLE
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:PO BOX 1377
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31534-1377
Mailing Address - Country:US
Mailing Address - Phone:912-384-1477
Mailing Address - Fax:912-384-1470
Practice Address - Street 1:2007 OCILLA RD
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-2229
Practice Address - Country:US
Practice Address - Phone:912-384-0162
Practice Address - Fax:912-384-4863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty