| Organization Name: | EMORY MEDICAL CORPORATION |
| NPI Number: | 1033542485 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMANDA BOLT (OFFICE MANAGER) |
| Mailing Address: | 1546 S Water St Ste. A Starke |
| State: | FL US |
| Postal Code: | 320914511 |
| Phone Number: | 9049644777 |
| Fax Number: | 9049644780 |
| NPI Enumeration Date: | 08/20/2013 |
| NPI Last Update Date: | 08/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |