Basic Information
| Provider Information | |||||||||
| NPI: | 1457846693 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CRH UMC LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | URGENT MEDICARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1275 HIGHWAY 54 W STE 201 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302144538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6786889685 | ||||||||
| FaxNumber: | 7706263791 | ||||||||
| Practice Location | |||||||||
| Address1: | 12287 HIGHWAY 231 431 N | ||||||||
| Address2: | |||||||||
| City: | MERIDIANVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 357591205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2568281154 | ||||||||
| FaxNumber: | 2568281194 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2018 | ||||||||
| LastUpdateDate: | 06/29/2018 | ||||||||
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| AuthorizedOfficialLastName: | MALIK-ROE | ||||||||
| AuthorizedOfficialFirstName: | ANDREA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6785046392 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.