Organization
EMMANUEL RIDGE COMMUNITY HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BEATRICE A EZEM RN, CM, CLNC (PRESIDENT/CEO)
(601) 927-9839
Entity
Organization
Contact information
Practice address
2073 HIGHWAY 49 S, SUITE A, FLORENCE, MS 39073-9422
(601) 709-3301
(601) 709-3308
Mailing address
2073 HIGHWAY 49 S, SUITE A, FLORENCE, MS 39073-9422
(601) 709-3301
(601) 709-3308
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119586
—
MS
05
—
00121128
—
MS
05
—
04036718
—
MS
01
—
16022
PHYSICIAN
MS
01
—
18216
PHYSICIAN
MS
01
—
R850959
FNP
MS
Enumeration date
11/02/2006
Last updated
09/11/2025
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