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Organization

CORNERSTONE HOSPICE LLC

Active
Other names
Cornerstone Hospice of Tulsa
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL BRENT MOORE R PH D (OWNER/PRESIDENT)
(918) 213-4973
Entity
Organization

Contact information

Practice address
501 E 5TH ST STE A, BARTLESVILLE, OK 74003-3942
(918) 213-4973
Mailing address
501 E 5TH ST STE A, BARTLESVILLE, OK 74003-3942
(918) 213-4973
(918) 213-4989

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
4146
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
371606
MEDICARE PROVIDER NUMBER
OK
Enumeration date
08/09/2005
Last updated
07/28/2022
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