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General NPI Number Information
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NPI Number | 1619240520
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Entity Type | Organization
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Legal Business Name | CORNERSTONE HEALTHCARE AGENCY LLC
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 314 W MAIN ST
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City | STROUD
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State | OK
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Zip | 74079-3612
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Country | US
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Telephone | 918-968-2002
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Fax | 918-968-2009
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Provider Business Mailing Address
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Address Line | 314 W MAIN ST PO BOX 1000
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City | STROUD
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State | OK
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Zip | 74079-3612
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Country | US
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Telephone | 191-896-8200
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Fax | 191-896-8200
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Authorized Official
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Title or Position | VICE PRESIDENT/ SECRETARY
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Name | MRS. REBECCA EVELYN TURPIN
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Credential | RN/CCM
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Telephone | 14059196651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7989
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License Number State | OK
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