Provider Demographics
NPI:1083797286
Name:CORNERSTONE SURGICAL CARE
Entity Type:Organization
Organization Name:CORNERSTONE SURGICAL CARE
Other - Org Name:CORNERSTONE SURGICAL CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ASHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-587-0522
Mailing Address - Street 1:5800 NW PRAIRIE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2764
Mailing Address - Country:US
Mailing Address - Phone:816-587-0522
Mailing Address - Fax:816-505-5004
Practice Address - Street 1:712 1ST TER
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043-1704
Practice Address - Country:US
Practice Address - Phone:913-727-6000
Practice Address - Fax:913-351-1346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSDN1779OtherMEDICARE RAILROAD
KS110867Medicare PIN