Provider Demographics
NPI:1760702930
Name:TRANSYLVANIA PHYSICIAN SERVICES, INC.
Entity Type:Organization
Organization Name:TRANSYLVANIA PHYSICIAN SERVICES, INC.
Other - Org Name:TRANSYLVANIA WOMEN'S CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF REVENUE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-651-4144
Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:828-213-1500
Mailing Address - Fax:828-651-6570
Practice Address - Street 1:87 MEDICAL PARK DR STE B
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3210
Practice Address - Country:US
Practice Address - Phone:828-884-8860
Practice Address - Fax:828-885-7164
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSYLVANIA PHYSICIAN SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-10
Last Update Date:2018-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207V00000X, 207VG0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC020W7OtherBCBS
NC1196489OtherGATEWAY HEALTH PLAN
NC6698830OtherUNITED HEALTHCARE