Healthcare Provider Details

I. General information

NPI: 1194155010
Provider Name (Legal Business Name): CORNERSTONE HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2013
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5292 S COLLEGE DR 304
MURRAY UT
84123-2991
US

IV. Provider business mailing address

5292 S COLLEGE DR 304
MURRAY UT
84123-2991
US

V. Phone/Fax

Practice location:
  • Phone: 801-716-7800
  • Fax: 877-676-6599
Mailing address:
  • Phone: 801-716-7800
  • Fax: 877-676-6599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateUT

VIII. Authorized Official

Name: DEBORAH A PETERS
Title or Position: CEO
Credential: RN
Phone: 801-913-7913