Organization
CRH PHYSICIAN PRACTICES LLC
Active
Other names
CRH Nicholls Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI LEWIS (CEO)
(912) 384-1900
Entity
Organization
Contact information
Practice address
804 N LIBERTY ST, NICHOLLS, GA 31554
(912) 384-4024
(912) 384-4040
Mailing address
1100 WARD STREET EXT W, DOUGLAS, GA 31533-1902
(912) 384-1477
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/29/2012
Last updated
07/24/2018
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