=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639305808
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CORNERSTONE HEALTH CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2009
-----------------------------------------------------
Last Update Date | 05/27/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 350 N COX ST SUITE 20
-----------------------------------------------------
City | ASHEBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27203-5514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-672-3200
-----------------------------------------------------
Fax | 336-629-7349
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1701 WESTCHESTER DR SUITE 850
-----------------------------------------------------
City | HIGH POINT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27262-7254
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-802-2536
-----------------------------------------------------
Fax | 336-802-2534
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT / CEO
-----------------------------------------------------
Name | ANNE C HILL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 336-802-2400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------