Healthcare Provider Details

I. General information

NPI: 1720804719
Provider Name (Legal Business Name): EMMANUEL FAMILY CLINIC-SALUDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W BUTLER AVE
SALUDA SC
29138-1313
US

IV. Provider business mailing address

501 W BUTLER AVE
SALUDA SC
29138-1313
US

V. Phone/Fax

Practice location:
  • Phone: 864-445-2250
  • Fax:
Mailing address:
  • Phone: 864-445-2250
  • Fax: 877-870-2854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSANA GIANNINA GARCIA
Title or Position: OFFICE MANAGER
Credential:
Phone: 864-445-2250