Provider Demographics
NPI:1598435059
Name:CRH MD MANAGEMENT LLC
Entity Type:Organization
Organization Name:CRH MD MANAGEMENT LLC
Other - Org Name:PATRIOT URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALIK ROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-504-6392
Mailing Address - Street 1:2675 PACES FERRY RD SE STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4099
Mailing Address - Country:US
Mailing Address - Phone:678-504-6392
Mailing Address - Fax:
Practice Address - Street 1:11804 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-3311
Practice Address - Country:US
Practice Address - Phone:410-870-5094
Practice Address - Fax:410-870-8076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty