Provider Demographics
NPI:1548233182
Name:CORNERSTONE MEDICAL CENTER, PA
Entity Type:Organization
Organization Name:CORNERSTONE MEDICAL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAE
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:MORRISEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-538-0565
Mailing Address - Street 1:1041 KIRKPATRICK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8148
Mailing Address - Country:US
Mailing Address - Phone:336-538-0565
Mailing Address - Fax:336-538-0564
Practice Address - Street 1:1041 KIRKPATRICK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8148
Practice Address - Country:US
Practice Address - Phone:336-538-0565
Practice Address - Fax:336-538-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890140AMedicaid
NC890140AMedicaid