Provider Demographics
NPI:1720804719
Name:EMMANUEL FAMILY CLINIC-SALUDA
Entity type:Organization
Organization Name:EMMANUEL FAMILY CLINIC-SALUDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:GISELLA
Authorized Official - Middle Name:ENID
Authorized Official - Last Name:GODOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-445-2550
Mailing Address - Street 1:501 W BUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:SC
Mailing Address - Zip Code:29138-1313
Mailing Address - Country:US
Mailing Address - Phone:864-445-2250
Mailing Address - Fax:
Practice Address - Street 1:501 W BUTLER AVE
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:SC
Practice Address - Zip Code:29138-1313
Practice Address - Country:US
Practice Address - Phone:864-445-2250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health