Provider Demographics
NPI:1659612661
Name:CRH MQ LLC
Entity Type:Organization
Organization Name:CRH MQ LLC
Other - Org Name:MEDIQUICK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-592-5847
Mailing Address - Street 1:75 14TH ST NE
Mailing Address - Street 2:SUITE 2700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3604
Mailing Address - Country:US
Mailing Address - Phone:404-815-9569
Mailing Address - Fax:404-410-4019
Practice Address - Street 1:140 PINNACLES DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2322
Practice Address - Country:US
Practice Address - Phone:386-597-2829
Practice Address - Fax:386-313-1923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care