Provider Demographics
NPI:1356677488
Name:BIG CREEK SURGICAL HOSPITAL, LLC
Entity Type:Organization
Organization Name:BIG CREEK SURGICAL HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HOLFINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-743-8400
Mailing Address - Street 1:15345 BAGLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4825
Mailing Address - Country:US
Mailing Address - Phone:440-743-8400
Mailing Address - Fax:
Practice Address - Street 1:15345 BAGLEY RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4825
Practice Address - Country:US
Practice Address - Phone:440-743-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-24
Last Update Date:2009-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHN/A284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital