| Cornerstone Family Healthcare | |
|
140 Hammond St Port Jervis NY 12771-2607 | |
| (845) 563-8000 | |
| Not Available |
| Full Name | Cornerstone Family Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 140 Hammond St, Port Jervis, New York |
| Authorized Official Name and Position | David Jolly (CEO) |
| Authorized Official Contact | 8452203165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Family Healthcare 2570 Route 9w Ste 10 Cornwall NY 12518-1370 Ph: (845) 220-3100 | Cornerstone Family Healthcare 140 Hammond St Port Jervis NY 12771-2607 Ph: (845) 563-8000 |
| NPI Number | 1831712629 |
|---|---|
| Provider Enumeration Date | 05/27/2020 |
| Last Update Date | 01/10/2023 |
| Medicare PECOS PAC ID | 4880610393 |
|---|---|
| Medicare Enrollment ID | O20180316000857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831712629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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