MEDICARE: CORNERSTONE PHARMACY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy
3	3336L0003X	Long Term Care Pharmacy	CF00003831	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	4920559	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4920559	OTHER	OTHER ID NUMBER

General Provider Information

NPI Number	:	1063573137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE PHARMACY SERVICES

Provider Business Mailing Address
First Line	:	2324 EASTLAKE AVE E
Second Line	:	E 400
City	:	SEATTLE
State	:	WA
Zip	:	98102-3345
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2324 EASTLAKE AVE E
Second Line	:	E 400
City	:	SEATTLE
State	:	WA
Zip	:	98102-3345
Country	:	US
Telephone Number	:	206-448-0932
Fax Number	:	206-956-9022

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT RHINEHART
Credential	:
Telephone Number	:	206-448-0932

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	07/31/2007

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Directions to “CORNERSTONE PHARMACY SERVICES ” Practice Location

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