1437361441 NPI number — CORNERSTONE CHIROPRACTIC INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437361441 NPI number — CORNERSTONE CHIROPRACTIC INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORNERSTONE CHIROPRACTIC INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437361441
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
319 21ST ST N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PELL CITY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35125-1725
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-683-6332
Provider Business Mailing Address Fax Number:
866-910-2391

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 19TH ST S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PELL CITY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35128-2007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-683-6332
Provider Business Practice Location Address Fax Number:
866-910-2391
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RICE
Authorized Official First Name:
BETH
Authorized Official Middle Name:
SPENCER
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
205-683-6332

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1584 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 515-22109 . This is a "BCBS-AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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