Healthcare Provider Details

I. General information

NPI: 1194489757
Provider Name (Legal Business Name): WALNUT CREEK SURGICAL SUITES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 BUCKLES COURT NORTH
GAHANNA OH
43230-6883
US

IV. Provider business mailing address

715 BUCKLES COURT NORTH
GAHANNA OH
43230-6883
US

V. Phone/Fax

Practice location:
  • Phone: 614-354-2462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERICA WEHRMEISTER
Title or Position: OFFICER/AUTHORIZED OFFICIAL
Credential:
Phone: 260-760-9420