Provider Demographics
NPI:1568715910
Name:CHG CORNERSTONE HOSPITAL OF LITTLE ROCK, LLC
Entity Type:Organization
Organization Name:CHG CORNERSTONE HOSPITAL OF LITTLE ROCK, LLC
Other - Org Name:CORNERSTONE HOSPITAL OF NORTH LITTLE ROCK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-621-6700
Mailing Address - Street 1:2200 ROSS AVE
Mailing Address - Street 2:STE 5400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-7918
Mailing Address - Country:US
Mailing Address - Phone:469-621-6700
Mailing Address - Fax:469-621-6672
Practice Address - Street 1:1400 BRADEN ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-3721
Practice Address - Country:US
Practice Address - Phone:501-985-7026
Practice Address - Fax:501-985-7162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR042010Medicare Oscar/Certification