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Ste. 201 Swarthmore PA 19081-2335 phone 877 297-8864 fax 888 965-8864 www. TransparentHealthGroup.com/Provider Providers TransparentHG.com PLEASE TYPE OR PRINT NEATLY I. Yes STATE/COUNTRY DEA NUMBER 2014 Transparent Health Group LLC ORIGINAL DATE No EXP. DATE III. Practice Information Type of Practice Solo Group Other Multi-specialty Group Names and Specialties of other members in your group. If you need additional space please attach sheets. Primary Hospital Name Status of Priv. Admits/Years...
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