Organization
CRISP REGIONAL HOSPITAL, INC.
Active
Parent organization
CRISP REGIONAL HOSPITAL, INC.
Other names
Rochelle Healthcare Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRISP REGIONAL HOSPITAL, INC.
Authorized official
JAMES MILLER (DIRECTOR PHYSICIAN PRACTICES)
(229) 271-4676
Entity
Organization
Contact information
Practice address
636 SECOND AVENUE, SW, ROCHELLE, GA 31079
(229) 365-2570
(229) 365-2571
Mailing address
636 SECOND AVENUE, SW, ROCHELLE, GA 31079
(229) 365-2570
(229) 365-2571
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000514H
—
GA
Enumeration date
05/17/2007
Last updated
05/27/2008
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