Basic Information
| Provider Information | |||||||||
| NPI: | 1942333893 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CORNERSTONE HEALTH CARE, PA | ||||||||
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| OtherOrganizationName: | CORNERSTONE CARDIOLOGY ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1701 WESTCHESTER DRIVE | ||||||||
| Address2: | SUITE 850 | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272627254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368022400 | ||||||||
| FaxNumber: | 3368022401 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 GATEWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272624822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368022125 | ||||||||
| FaxNumber: | 3368022126 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2007 | ||||||||
| LastUpdateDate: | 07/13/2009 | ||||||||
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| AuthorizedOfficialLastName: | BECK | ||||||||
| AuthorizedOfficialFirstName: | KATHY | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 3368022440 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | CC4243 | 01 | NC | RR MEDICARE | OTHER | 01537 | 01 | NC | BCBS | OTHER | 25416 | 01 | NC | MEDCOST | OTHER | 8901537 | 05 | NC | MEDICAID | CB8658 | 01 | NC | RR MEDICARE | OTHER | CC4241 | 01 | NC | RR MEDICARE | OTHER | 7122710 | 01 | NC | AETNA | OTHER | CD6614 | 01 | NC | RR MEDICARE | OTHER |