MEDICARE: CORNERSTONE CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	304459	OTHER	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1302933	OTHER	GATEWAY
4	2504615	OTHER	HIGHMARK
5	72344	OTHER	UNISON

General Provider Information

NPI Number	:	1144526419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE CARE, INC

Provider Business Mailing Address
First Line	:	140 N BEESON AVE
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-2937
Country	:	US
Telephone Number	:	724-439-1628
Fax Number	:	724-439-0171

Provider Business Practice Location Address
First Line	:	140 N BEESON AVE
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-2937
Country	:	US
Telephone Number	:	724-439-1628
Fax Number	:	724-439-0171

Authorized Official
Title or Position	:	CEO
Name	:	MR. ROBERT MTJOY
Credential	:	CEO
Telephone Number	:	724-943-3308

Provider Enumeration Date	:	02/04/2011
Last Update Date	:	03/11/2011

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Directions to “CORNERSTONE CARE, INC ” Practice Location

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