Provider Demographics
NPI:1952488520
Name:CORNERSTONE MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:CORNERSTONE MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUBINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-267-6555
Mailing Address - Street 1:115 HURLEY RD STE 4A
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06478-1046
Mailing Address - Country:US
Mailing Address - Phone:203-267-6555
Mailing Address - Fax:203-267-6565
Practice Address - Street 1:115 HURLEY RD STE 4A
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:CT
Practice Address - Zip Code:06478-1046
Practice Address - Country:US
Practice Address - Phone:203-267-6555
Practice Address - Fax:203-267-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004188943Medicaid
CT1231120001Medicare ID - Type UnspecifiedMEDICARE PROVIDER