1578658647 NPI number — COMMUNITY CORNERSTONES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578658647 NPI number — COMMUNITY CORNERSTONES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY CORNERSTONES 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:
Provider Other Organization Name Type Code:
6
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:
1578658647
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1549 CALLE ALDA
Provider Second Line Business Mailing Address:
URBANIZACION CARIBE
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-2709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-622-9797
Provider Business Mailing Address Fax Number:
787-622-9888

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URBANIZACION SANTA MARIA SHOPPING CENTER OFICINA 234
Provider Second Line Business Practice Location Address:
COMMUNITY CORNERSTONES, INC.
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00731-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-651-0030
Provider Business Practice Location Address Fax Number:
787-651-0033
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LAFITA
Authorized Official First Name:
SARA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF AMBULATORY SERVICES
Authorized Official Telephone Number:
787-622-9797

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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