Healthcare Provider Details

I. General information

NPI: 1811142037
Provider Name (Legal Business Name): CORNERSTONE HEALTH VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2008
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34099 MELINZ PKWY UNIT G
EASTLAKE OH
44095-4041
US

IV. Provider business mailing address

34099 MELINZ PKWY UNIT G
EASTLAKE OH
44095-4041
US

V. Phone/Fax

Practice location:
  • Phone: 440-953-0604
  • Fax: 440-953-0943
Mailing address:
  • Phone: 440-953-0604
  • Fax: 440-953-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number021914350
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY PINKERTON
Title or Position: PRESIDENT
Credential:
Phone: 440-953-0604