Healthcare Provider Details

I. General information

NPI: 1922349083
Provider Name (Legal Business Name): CRH UMC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2013
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7583 WALL TRIANA HWY
MADISON AL
35757-8327
US

IV. Provider business mailing address

75 14TH ST NE SUITE 2700
ATLANTA GA
30309-3604
US

V. Phone/Fax

Practice location:
  • Phone: 256-830-5777
  • Fax: 256-830-6926
Mailing address:
  • Phone: 404-815-9569
  • Fax: 404-410-4019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM C MILLER
Title or Position: CEO
Credential:
Phone: 678-592-5847