Provider Demographics
NPI:1528182623
Name:CORNERSTONE HEALTH CARE, PA
Entity Type:Organization
Organization Name:CORNERSTONE HEALTH CARE, PA
Other - Org Name:PIEDMONT UROLOGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-802-2400
Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2534
Mailing Address - Fax:336-802-2536
Practice Address - Street 1:218 GATEWOOD AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4877
Practice Address - Country:US
Practice Address - Phone:336-802-2030
Practice Address - Fax:336-802-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC026OtherTRICARE
NC22157OtherMEDCOST
NCCC6608OtherRR MEDICARE
NCD266OtherPARTNERS MEDICARE CHOICE
NC890330CMedicaid
NCCF9200OtherRR MEDICARE
NCCB8658OtherRRMC
NCCC5472OtherRR MEDICARE
NCCD6614OtherRR MEDICARE
NCCC4241OtherRR MEDICARE
NCCC4243OtherRR MEDICARE
NC7070781OtherAETNA
NCCC4242OtherRR MEDICARE
NC0330COtherBCBS
NC269374OtherMAMSI
NC7070781OtherAETNA
NC2318873Medicare PIN