1235263070 NPI number — CORNERSTONE HOME HEALTH, INC.

Table of content: (NPI 1235263070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235263070 NPI number — CORNERSTONE HOME HEALTH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORNERSTONE HOME HEALTH, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CORNERSTONE HOME CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235263070
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8800 GLACIER HWY.
Provider Second Line Business Mailing Address:
SUITE 111
Provider Business Mailing Address City Name:
JUNEAU
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99801-8079
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-586-6838
Provider Business Mailing Address Fax Number:
907-586-8114

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8800 GLACIER HWY.
Provider Second Line Business Practice Location Address:
SUITE 111
Provider Business Practice Location Address City Name:
JUNEAU
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99801-8079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-586-6838
Provider Business Practice Location Address Fax Number:
907-586-8114
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HENRIQUES
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT/ASST ADMINISTRATOR
Authorized Official Telephone Number:
907-586-6838

Provider Taxonomy Codes

  • Taxonomy code: 251X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1028142 , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1581941 , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1028144 , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: PCG974 , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1028296 , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".




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