Provider Demographics
NPI:1952836504
Name:CRH PHYSICIAN PRACTICES, LLC
Entity Type:Organization
Organization Name:CRH PHYSICIAN PRACTICES, LLC
Other - Org Name:CRH SURGICAL GROUP-ALMA
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:912-384-1477
Mailing Address - Street 1:PO BOX 14804
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4043
Mailing Address - Country:US
Mailing Address - Phone:912-384-5832
Mailing Address - Fax:912-383-8279
Practice Address - Street 1:204 E 15TH ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:GA
Practice Address - Zip Code:31510-2908
Practice Address - Country:US
Practice Address - Phone:912-384-5832
Practice Address - Fax:912-383-8279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty