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NPI Code Detail

MEDICARE: CORNERSTONE PHARMACY INC

MEDICARE: CORNERSTONE PHARMACY 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy054.020815IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12177600OTHERPK

General Provider Information

NPI Number : 1558850545
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORNERSTONE PHARMACY INC
Provider Business Mailing Address
First Line : 10555 S EWING AVE
Second Line : FIRST FLOOR
City : CHICAGO
State : IL
Zip : 60617-6200
Country : US
Telephone Number : 773-902-2356
Fax Number : 773-902-2458
Provider Business Practice Location Address
First Line : 10555 S EWING AVE
Second Line : FIRST FLOOR
City : CHICAGO
State : IL
Zip : 60617-6200
Country : US
Telephone Number : 773-902-2356
Fax Number : 773-902-2458
Authorized Official
Title or Position : OWNER/AO
Name : DANNIELA OLMOS FIGUEROA
Credential :
Telephone Number : 773-844-3455
Provider Enumeration Date : 05/04/2018
Last Update Date : 07/19/2018

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Directions to “CORNERSTONE PHARMACY INC ” Practice Location

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