Provider Demographics
NPI: | 1164806568 |
---|---|
Name: | CORNERSTONE HEALTH CARE, PA |
Entity type: | Organization |
Organization Name: | CORNERSTONE HEALTH CARE, PA |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | BUSINESS SERVICES OPERATIONS OFFICE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANNE |
Authorized Official - Middle Name: | C |
Authorized Official - Last Name: | HILL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 336-802-2400 |
Mailing Address - Street 1: | 1701 WESTCHESTER DR |
Mailing Address - Street 2: | STE 850 |
Mailing Address - City: | HIGH POINT |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27262-7008 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-802-2400 |
Mailing Address - Fax: | 336-802-2534 |
Practice Address - Street 1: | 1593 YANCEYVILLE ST |
Practice Address - Street 2: | STE 200 |
Practice Address - City: | GREENSBORO |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27405-6948 |
Practice Address - Country: | US |
Practice Address - Phone: | 336-230-0402 |
Practice Address - Fax: | 336-230-1761 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-07-15 |
Last Update Date: | 2015-08-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty |