Emory Medical Corporation

NPI #1033542485 in Starke, Florida

Provider Information

NPI Number: 1033542485
Entity Type: Organization
Organization Name: Emory Medical Corporation
Subpart: Yes (part of a larger organization)
Parent Organization: EMORY MEDICAL CORPORATION
Primary Specialty: Specialist
Enumeration Date: Aug 20, 2013
Last Updated: Aug 22, 2013

Practice Location

Address: 1546 S WATER ST
Address 2: STE. A
City: Starke
State: Florida
ZIP Code: 32091-4511
Phone: (904) 964-4777

Authorized Official

Name: MRS. AMANDA BOLT
Title: OFFICE MANAGER
Phone: (386) 466-1106

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rural Health — Rural Health	261QR1300X
Clinic/Center - Primary Care — Primary Care	261QP2300X
Specialist	174400000X	Primary

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