Healthcare Provider Details
I. General information
NPI: 1679737696
Provider Name (Legal Business Name): TRANSYLVANIA PHYSICIAN SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/18/2008
Last Update Date: 04/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
89 HOSPITAL DR STE A
BREVARD NC
28712-4838
US
IV. Provider business mailing address
PO BOX 602373
CHARLOTTE NC
28260-2373
US
V. Phone/Fax
- Phone: 828-862-6368
- Fax: 828-885-5742
- Phone: 828-213-1500
- Fax: 828-651-6570
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204F00000X |
| Taxonomy | Transplant Surgery Physician |
| License Number | |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | |
| License Number State | NC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | |
| License Number State | NC |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | NC |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086X0206X |
| Taxonomy | Surgical Oncology Physician |
| License Number | |
| License Number State | NC |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | |
| License Number State | NC |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | NC |
VIII. Authorized Official
Name:
RHONDA
A
MILLER
Title or Position: CHIEF REVENUE OFFICER
Credential:
Phone: 828-651-4144