| Cornerstone Family Healthcare | |
|
2082 Mesquite Ave Suite 106 Lake Havasu City AZ 86403-6710 | |
| (928) 680-4233 | |
| (928) 680-6522 |
| Full Name | Cornerstone Family Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 2082 Mesquite Ave, Lake Havasu City, Arizona |
| Authorized Official Name and Position | Teresa J Tibbetts (OWNER) |
| Authorized Official Contact | 9286804233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Family Healthcare 2082 Mesquite Ave Suite 106 Lake Havasu City AZ 86403-6710 Ph: (928) 680-4233 | Cornerstone Family Healthcare 2082 Mesquite Ave Suite 106 Lake Havasu City AZ 86403-6710 Ph: (928) 680-4233 |
| NPI Number | 1881941169 |
|---|---|
| Provider Enumeration Date | 08/06/2012 |
| Last Update Date | 08/06/2012 |
| Medicare PECOS PAC ID | 4789834292 |
|---|---|
| Medicare Enrollment ID | O20121018000370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881941169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Megan M Randall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306270145 PECOS PAC ID: 6103042429 Enrollment ID: I20140723000556 |
| Provider Name | Kasey A Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861905416 PECOS PAC ID: 9931461944 Enrollment ID: I20180402001155 |
| Provider Name | Tiffany Michelle Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447991724 PECOS PAC ID: 5799169694 Enrollment ID: I20220825004082 |
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