MEDICARE: TRANSYLVANIA COMMUNITY HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	12595	NC

General Provider Information

NPI Number	:	1932587250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSYLVANIA COMMUNITY HOSPITAL

Provider Business Mailing Address
First Line	:	2 MEDICAL PARK DR
Second Line	:	SUITE 101
City	:	ASHEVILLE
State	:	NC
Zip	:	28803-7782
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16821 ROSMAN HWY
Second Line	:
City	:	LAKE TOXAWAY
State	:	NC
Zip	:	28747-9593
Country	:	US
Telephone Number	:	828-883-5473
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR-RETAIL PHARMACY
Name	:	TIMOTHY GENTILCORE
Credential	:	PHARM.D.
Telephone Number	:	828-213-0048

Provider Enumeration Date	:	05/07/2015
Last Update Date	:	10/21/2015

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