Emmanuel Ridge Community Health Clinic

LBN: Emmanuel Ridge Community Health Clinic
Emmanuel Ridge Community Health Clinic is an health care organization with primary practice located at 2073 Highway 49 S Suite A, Florence MS 39073-9422. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Community Health, Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Community Health is the primary health care specialty. Emmanuel Ridge Community Health Clinic can be contacted via phone (601) 709-3301, or through Ezem, Beatrice A via phone (601) 927-9839.

Contact Information

Primary practice address
2073 Highway 49 S Suite A Florence MS 39073-9422
Phone: (601) 709-3301
Fax: (601) 709-3308
Website:
Map and Directions
Authorized official contact:
Name: Ezem, Beatrice A RN, CM, CLNC
Phone: (601) 927-9839

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Community Health 261QC1500X
Ambulatory Health Care Facilities / Primary Care 261QP2300X
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1679652754
LBN Legal business name Emmanuel Ridge Community Health Clinic
DBA Doing business as
Authorized official Ezem, Beatrice A RN, CM, CLNC
Entity Organization
Organization subpart 1 No
Enumeration date Nov 2nd, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679652754 NPPES
Mississippi Other 16022 PHYSICIAN
Mississippi MEDICAID 00119586 PHYSICIAN
Mississippi MEDICAID 04036718 PHYSICIAN
Mississippi Other R850959 PHYSICIAN
Mississippi MEDICAID 00121128 PHYSICIAN
Mississippi Other 18216 PHYSICIAN

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