Healthcare Provider Details

I. General information

NPI: 1871159145
Provider Name (Legal Business Name): CORNERSTONE HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 1ST ST E
CONOVER NC
28613-1715
US

IV. Provider business mailing address

PO BOX 603086
CHARLOTTE NC
28260-3086
US

V. Phone/Fax

Practice location:
  • Phone: 828-464-3821
  • Fax:
Mailing address:
  • Phone: 336-716-1331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE FLYNN HENRY
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 336-716-1331