Basic Information
Provider Information
NPI: 1619341898
EntityType: 2
ReplacementNPI:  
OrganizationName: CORNERSTONE HEALTHCARE LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CORNERSTONE PHYSICAL THERAPY AT PREMIER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: 1701 WESTCHESTER DR
Address2: SUITE 850
City: HIGH POINT
State: NC
PostalCode: 272627008
CountryCode: US
TelephoneNumber: 3368022536
FaxNumber: 3368022534
Practice Location
Address1: 4515 PREMIER DR
Address2: SUITE 307A
City: HIGH POINT
State: NC
PostalCode: 272658357
CountryCode: US
TelephoneNumber: 3368022180
FaxNumber: 3368022181
Other Information
ProviderEnumerationDate: 11/25/2015
LastUpdateDate: 05/27/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HILL
AuthorizedOfficialFirstName: ANNE
AuthorizedOfficialMiddleName: C
AuthorizedOfficialTitleorPosition: BUSINESS OPERATIONS OFFICER
AuthorizedOfficialTelephone: 3368022536
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  Y193200000X MULTI-SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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