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General NPI Number Information
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NPI Number | 1841585403
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Entity Type | Organization
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Legal Business Name | CORNERSTONE DISTRIBUTION LLC
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Dates
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Enumeration Date | 06/12/2011
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Last Update Date | 04/25/2013
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Provider Practice Location Address
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Address Line | 6214 MORENCI TRL SUITE 100
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-4871
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Country | US
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Telephone | 317-755-2731
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Fax | 317-755-2657
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Provider Business Mailing Address
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Address Line | 6214 MORENCI TRL SUITE 100
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-4871
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Country | US
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Telephone | 317-755-2731
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Fax | 317-755-2657
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Authorized Official
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Title or Position | COO
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Name | MRS. TAMMIE R. MARTIN
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Credential | MSM
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Telephone | 317-755-2731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | IN
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