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Organization

EMMAUS COMMUNITY HEALTHCARE, PLLC

Active
Other names
DBA: Piney Flats Urgent Care
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES L BACKUS III DO (AUTHORIZED OFFICIAL)
(423) 538-5202
Entity
Organization

Contact information

Practice address
6419 BRISTOL HIGHWAY, PINEY FLATS, TN 37686
(423) 538-5202
(423) 538-8208
Mailing address
509 MEDTECH PKWY, JOHNSON CITY, TN 37604
(423) 952-2122
(423) 952-2145

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
208D00000X
General Practice Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3726460
TN
01
DD0861
RR
TN
Enumeration date
06/29/2006
Last updated
10/07/2025
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