Provider Demographics
NPI:1861941379
Name:TRANSCEND CORPORATE NUTRITION
Entity type:Organization
Organization Name:TRANSCEND CORPORATE NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:DWYER
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:704-640-4161
Mailing Address - Street 1:2828 YORKVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-1102
Mailing Address - Country:US
Mailing Address - Phone:704-640-4161
Mailing Address - Fax:
Practice Address - Street 1:2828 YORKVIEW CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-1102
Practice Address - Country:US
Practice Address - Phone:704-640-4161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC818708133V00000X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty