Basic Information
Provider Information | |||||||||
NPI: | 1376613703 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | TRANSYLVANIA COMMUNITY HOSPITAL, INC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 260 HOSPITAL DR | ||||||||
Address2: |   | ||||||||
City: | BREVARD | ||||||||
State: | NC | ||||||||
PostalCode: | 287123378 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8288849111 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 260 HOSPITAL DR | ||||||||
Address2: |   | ||||||||
City: | BREVARD | ||||||||
State: | NC | ||||||||
PostalCode: | 287123378 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8288849111 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/09/2006 | ||||||||
LastUpdateDate: | 08/13/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | CARVER | ||||||||
AuthorizedOfficialFirstName: | LENORA | ||||||||
AuthorizedOfficialMiddleName: | JANE MOODY | ||||||||
AuthorizedOfficialTitleorPosition: | CREDENTIALS SPECIALIST | ||||||||
AuthorizedOfficialTelephone: | 8288626399 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | MRS. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | H0111 | NC | Y |   | Hospitals | General Acute Care Hospital | Critical Access |
ID Information
ID | Type | State | Issuer | Description | 3401319 | 05 | NC |   | MEDICAID | 5070733 | 01 | NC | UHC OUTPATIENT | OTHER | 335970 | 01 | SC | MEDICAID OF SC OUTPATIENT | OTHER | 00546 | 01 | NC | BCBSNC OUTPATIENT | OTHER | 9108424-00 | 01 | FL | MEDICAID OF FL OUTPATIENT | OTHER |