MEDICARE: CORNERSTONE MEDICAL SERVICES OF COLUMBUS LLC

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	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1164397790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE MEDICAL SERVICES OF COLUMBUS LLC

Provider Business Mailing Address
First Line	:	555 E NORTH LN STE 5075
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2490
Country	:	US
Telephone Number	:	610-424-4515
Fax Number	:

Provider Business Practice Location Address
First Line	:	5995 WILCOX PL STE C
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-9267
Country	:	US
Telephone Number	:	614-379-6631
Fax Number	:

Authorized Official
Title or Position	:	AO/ CCO
Name	:	WENDY RUSSALESI
Credential	:
Telephone Number	:	484-246-9499

Provider Enumeration Date	:	10/06/2025
Last Update Date	:	10/06/2025

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