Organization
CORNERSTONE HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L LYONS (OFFICE MANAGER)
(740) 423-5535
Entity
Organization
Contact information
Practice address
204 STONE RD, BELPRE, OH 45714-2348
(740) 423-5535
(740) 423-5254
Mailing address
204 STONE RD, BELPRE, OH 45714-2348
(740) 423-5535
(740) 423-5254
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1390252
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010309000
—
WV
01
—
001710673
BLUE CROSS BLUE SHIELD
—
05
—
2002102
—
OH
01
—
CN4410
RAILROAD MEDICARE GROUP NUMBER
—
Enumeration date
01/08/2007
Last updated
04/29/2008
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