Basic Information
Provider Information
NPI: 1245867977
EntityType: 2
ReplacementNPI:  
OrganizationName: CORNERSTONE MEDICAL SERVICES- MIDWEST, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: AEROCARE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3325 BARTLETT BLVD
Address2:  
City: ORLANDO
State: FL
PostalCode: 328116428
CountryCode: US
TelephoneNumber: 4075152070
FaxNumber:  
Practice Location
Address1: 701 WHITE POND DR STE 210
Address2:  
City: AKRON
State: OH
PostalCode: 443201193
CountryCode: US
TelephoneNumber: 3302943636
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/24/2020
LastUpdateDate: 02/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GRIGGS
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: CEO/ PRESIDENT
AuthorizedOfficialTelephone: 4072060040
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: AEROCARE HOLDINGS, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  N SuppliersDurable Medical Equipment & Medical Supplies 
332BX2000X  Y SuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies

No ID Information.


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