Healthcare Provider Details
I. General information
NPI: 1790800571
Provider Name (Legal Business Name): CORNERSTONE HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2007
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1814 WESTCHESTER DRIVE SUITE 300
HIGH POINT NC
27262-7369
US
IV. Provider business mailing address
1701 WESTCHESTER DR STE 850
HIGH POINT NC
27262-7254
US
V. Phone/Fax
- Phone: 336-802-2055
- Fax: 336-802-2056
- Phone: 336-802-2536
- Fax: 336-802-2534
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0000X |
| Taxonomy | Sports Medicine Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANNE
C
HILL
Title or Position: BUSINESS SERVICES OFFICER
Credential:
Phone: 336-802-2400