Organization
BIRCHCREST HOLDINGS, LLC
Active
Other names
PDI SOUTH
Organization subpart
No
Provider details
NPI number
Authorized official
JACK CORNELL (PRESIDENT)
(216) 765-8390
Entity
Organization
Contact information
Practice address
4760 RICHMOND RD STE 300, CLEVELAND, OH 44128
(216) 765-8390
(216) 765-8392
Mailing address
4760 RICHMOND RD STE 300, CLEVELAND, OH 44128-5979
(216) 765-8390
(216) 765-8392
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
01/03/2011
Last updated
08/23/2018
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