Provider Demographics
| NPI: | 1164806568 |
|---|---|
| Name: | CORNERSTONE HEALTH CARE, PA |
| Entity type: | Organization |
| Organization Name: | CORNERSTONE HEALTH CARE, PA |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | BUSINESS SERVICES OPERATIONS OFFICE |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | ANNE |
| Authorized Official - Middle Name: | C |
| Authorized Official - Last Name: | HILL |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 336-802-2400 |
| Mailing Address - Street 1: | 1701 WESTCHESTER DR |
| Mailing Address - Street 2: | STE 850 |
| Mailing Address - City: | HIGH POINT |
| Mailing Address - State: | NC |
| Mailing Address - Zip Code: | 27262-7008 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 336-802-2400 |
| Mailing Address - Fax: | 336-802-2534 |
| Practice Address - Street 1: | 1593 YANCEYVILLE ST |
| Practice Address - Street 2: | STE 200 |
| Practice Address - City: | GREENSBORO |
| Practice Address - State: | NC |
| Practice Address - Zip Code: | 27405-6948 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 336-230-0402 |
| Practice Address - Fax: | 336-230-1761 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2015-07-15 |
| Last Update Date: | 2015-08-18 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty |