MEDICARE: CRH MD MANAGEMENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1598435059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRH MD MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	2675 PACES FERRY RD SE STE 200
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-4099
Country	:	US
Telephone Number	:	678-504-6392
Fax Number	:

Provider Business Practice Location Address
First Line	:	11804 REISTERSTOWN RD
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-3311
Country	:	US
Telephone Number	:	410-870-5094
Fax Number	:	410-870-8076

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDREA MALIK ROE
Credential	:
Telephone Number	:	678-504-6392

Provider Enumeration Date	:	09/16/2021
Last Update Date	:	05/06/2026

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