Organization
EMMANUEL RIDGE COMM PHCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEATRICE EZEM RN CM CLNC (PRESIDENT)
(601) 927-9839
Entity
Organization
Contact information
Practice address
2073 HIGHWAY 49 S, FLORENCE, MS 39073-9422
(601) 845-3544
(601) 845-3636
Mailing address
PO BOX 1522, FLORENCE, MS 39073-1522
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
06939011
MS
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2586622
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
09/11/2025
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