Healthcare Provider Details

I. General information

NPI: 1023323664
Provider Name (Legal Business Name): CORNERSTONE HEALTH CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 PREMIER DRIVE SUITE 104
HIGH POINT NC
27265-8357
US

IV. Provider business mailing address

1701 WESTCHESTER DRIVE SUITE 850
HIGH POINT NC
27262-7254
US

V. Phone/Fax

Practice location:
  • Phone: 336-802-2250
  • Fax: 336-802-2251
Mailing address:
  • Phone: 336-802-2536
  • Fax: 336-802-2534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: GRACE E TERRELL
Title or Position: PRESIDENT / CEO
Credential:
Phone: 336-802-2400