Provider Demographics
NPI:1275666125
Name:CORNERSTONE HEALTH CARE, PA
Entity type:Organization
Organization Name:CORNERSTONE HEALTH CARE, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-802-2400
Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:721 N ELM ST
Practice Address - Street 2:SUITE 102
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3928
Practice Address - Country:US
Practice Address - Phone:336-802-2010
Practice Address - Fax:336-802-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890246RMedicaid
NCCC4241OtherRR MEDICARE
NCCC4242OtherRR MEDICARE
NCCD6614OtherRR MEDICARE
22742OtherMEDCOST
7100720OtherAETNA
NCCC4243OtherRR MEDICARE
NC0246ROtherBCBS
NCCC5472OtherRRMC
NCCC6608OtherRR MEDICARE
NCD266OtherPARTNERS MEDICARE CHOICE
269374OtherMAMSI
NCCB8658OtherRR MEDICARE
NCCF9200OtherRR MEDICARE
NCCF9200OtherRR MEDICARE
NC2318873Medicare PIN
NCCC4241OtherRR MEDICARE