1780922831 NPI number — CORNERSTONE HEALTH CARE PA

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 1780922831 NPI number — CORNERSTONE HEALTH CARE PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORNERSTONE HEALTH CARE PA
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:
1780922831
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1701 WESTCHESTER DR
Provider Second Line Business Mailing Address:
SUITE 850
Provider Business Mailing Address City Name:
HIGH POINT
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27262-7008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-802-2536
Provider Business Mailing Address Fax Number:
336-802-2534

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
445 PINEVIEW DR
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
KERNERSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27284-3817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-765-0710
Provider Business Practice Location Address Fax Number:
336-765-0821
Provider Enumeration Date:
01/24/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RICHE
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
SUE
Authorized Official Title or Position:
BUSINESS SERVICE DIRECTOR
Authorized Official Telephone Number:
336-802-2536

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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