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General NPI Number Information
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NPI Number | 1770981342
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Entity Type | Organization
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Legal Business Name | CORNERSTONE HEALTH CARE PA
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Dates
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Enumeration Date | 12/15/2014
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 4515 PREMIER DR SUITE 204
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City | HIGH POINT
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State | NC
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Zip | 27265-8357
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Country | US
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Telephone | 336-802-2015
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Fax |
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Provider Business Mailing Address
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Address Line | 9276 SCRANTON RD SUITE 100
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City | SAN DIEGO
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State | CA
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Zip | 92121-7701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | KENNY HEINE
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Credential |
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Telephone | 858-964-1506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 9300122
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License Number State | NC
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