Provider Demographics
NPI:1053312777
Name:CORNERSTONE HOSPICE INC.
Entity Type:Organization
Organization Name:CORNERSTONE HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:602-263-0925
Mailing Address - Street 1:7310 N 16TH ST
Mailing Address - Street 2:230
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5258
Mailing Address - Country:US
Mailing Address - Phone:602-263-0925
Mailing Address - Fax:602-263-0929
Practice Address - Street 1:7310 N 16TH ST
Practice Address - Street 2:230
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5258
Practice Address - Country:US
Practice Address - Phone:602-263-0925
Practice Address - Fax:602-263-0929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ031554Medicare Oscar/Certification