Provider Demographics
NPI:1245794585
Name:CORNERSTONE HEALTHCARE MANAGEMENT COMPANY LLC
Entity Type:Organization
Organization Name:CORNERSTONE HEALTHCARE MANAGEMENT COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNDAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOLARIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MBA, MPM
Authorized Official - Phone:317-331-3872
Mailing Address - Street 1:8350 DITCH RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2721
Mailing Address - Country:US
Mailing Address - Phone:317-331-3872
Mailing Address - Fax:
Practice Address - Street 1:8350 DITCH RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2721
Practice Address - Country:US
Practice Address - Phone:317-331-3872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNERSOTNE INVESTMENT COOPERATIVE SOCIETY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health