| Organization Name: | EMMAUS COMMUNITY HEALTHCARE |
| NPI Number: | 1356379093 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES L BACKUS (AUTHORIZED OFFICIAL) |
| Mailing Address: | 6419 Bristol Highway Piney Flats |
| State: | TN US |
| Postal Code: | 37686 |
| Phone Number: | 4235385202 |
| Fax Number: | 4235388208 |
| NPI Enumeration Date: | 06/29/2006 |
| NPI Last Update Date: | 04/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |