Provider Demographics
NPI:1366606550
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:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-802-2400
Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:306 WESTWOOD AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4341
Practice Address - Country:US
Practice Address - Phone:336-885-6168
Practice Address - Fax:336-885-8523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5913178Medicaid
NC5950571Medicaid
NCCC4243OtherRR MEDICARE
NC5950570Medicaid
NC5950569Medicaid
NC5950572Medicaid
NC5912895Medicaid
NC5950573Medicaid
NCCB8658OtherRR MEDICARE
NCCC4241OtherRR MEDICARE
NCCD6614OtherRR MEDICARE
NC5912895Medicaid