Organization
CRH PEACHTREE PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA MALIK ROE (PRESIDENT/CO-FOUNDER)
(678) 504-6392
Entity
Organization
Contact information
Practice address
315 W PONCE DE LEON AVE, DECATUR, GA 30030-2400
(678) 679-6471
Mailing address
315 W PONCE DE LEON AVE, DECATUR, GA 30030-2400
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/13/2026
Last updated
01/29/2026
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