Provider Demographics
NPI:1932587250
Name:TRANSYLVANIA COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:TRANSYLVANIA COMMUNITY HOSPITAL
Other - Org Name:MISSION PHARMACY - LAKE TOXAWAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR-RETAIL PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GENTILCORE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:828-213-0048
Mailing Address - Street 1:2 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-7782
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16821 ROSMAN HWY
Practice Address - Street 2:
Practice Address - City:LAKE TOXAWAY
Practice Address - State:NC
Practice Address - Zip Code:28747-9593
Practice Address - Country:US
Practice Address - Phone:828-883-5473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MISSION HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-07
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC125953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy