Organization
CORNERSTONE HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L LYONS (OFFICE MANAGER)
(304) 424-4129
Entity
Organization
Contact information
Practice address
2601 DUDLEY AVE, PARKERSBURG, WV 26101-2649
(304) 422-9157
(304) 422-9159
Mailing address
2601 DUDLEY AVE, PARKERSBURG, WV 26101-2649
(304) 422-9157
(304) 422-9159
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
51D0857928
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001705559
MSBCBS PAY TO ID
WV
05
—
2002102
—
OH
05
—
3810002430
—
WV
01
—
51D0857928
CLIA PROVIDER #
WV
01
—
9287211
MEDICARE GROUP
—
Enumeration date
01/08/2007
Last updated
11/26/2008
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