Healthcare Provider Details

I. General information

NPI: 1952488520
Provider Name (Legal Business Name): CORNERSTONE MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 HURLEY RD STE 4A
OXFORD CT
06478-1046
US

IV. Provider business mailing address

115 HURLEY RD STE 4A
OXFORD CT
06478-1046
US

V. Phone/Fax

Practice location:
  • Phone: 203-267-6555
  • Fax: 203-267-6565
Mailing address:
  • Phone: 203-267-6555
  • Fax: 203-267-6565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: GUY J RUBINO
Title or Position: OWNER
Credential:
Phone: 203-267-6555