Healthcare Provider Details

I. General information

NPI: 1679402358
Provider Name (Legal Business Name): CRH MD MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 SAINT LOLA LANE STE 101
BOWIE MD
20716
US

IV. Provider business mailing address

3500 SAINT LOLA LANE STE 101
BOWIE MD
20716
US

V. Phone/Fax

Practice location:
  • Phone: 301-531-4700
  • Fax: 301-531-4702
Mailing address:
  • Phone: 301-531-4700
  • Fax: 301-531-4702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHANDI FAULK
Title or Position: VP OF BILLING OPERATIONS
Credential:
Phone: 678-679-6471