NPIMap

Organization Active NPI

Emmanuel Ridge Home Care Agency Inc

Doing business as Emmanuel Ridge Escorted Transportation Services

  • Non-emergency Medical Transport (VAN)
  • Florence, MS
National Provider Identifier
1235314634
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
03056516 Issued in MS
Legal business name
EMMANUEL RIDGE HOME CARE AGENCY INC
Doing business as
Emmanuel Ridge Escorted Transportation Services
Practice address
2073 Hwy 49 South
Florence, MS 39073-1944
Phone
(601) 709-3304
Fax
(601) 709-3307
NPI assigned
Jan 3, 2008
Last updated
Jan 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Beatrice A Ezem, RN, CM, CLNC
Title
President/ Ceo
Phone
(601) 927-9839

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 03056516 MS Primary

Addresses

Primary practice location

2073 Hwy 49 South
Florence, MS 39073-1944

Mailing address

2073 Hwy 49 South
Florence, MS 39073-1944
Phone (601) 709-3304

Other identifiers 1

IdentifierTypeStateIssuer
03056516MedicaidMS

Other names 1

  • Emmanuel Ridge Escorted Transportation Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Emmanuel Ridge Home Care Agency Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2073 Highway 49 S
Florence, MS 39073
Phone (601) 709-3304

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1235314634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2073 HWY 49 SOUTH",
            "city": "FLORENCE",
            "state": "MS",
            "postal_code": "390731944",
            "telephone_number": "601-709-3304",
            "fax_number": "601-709-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2073 HWY 49 SOUTH",
            "city": "FLORENCE",
            "state": "MS",
            "postal_code": "390731944",
            "telephone_number": "601-709-3304",
            "fax_number": "601-709-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL RIDGE HOME CARE AGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "EZEM",
        "authorized_official_first_name": "BEATRICE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/ CEO",
        "authorized_official_telephone_number": "601-927-9839",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, CM, CLNC"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MS",
            "license": "03056516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03056516",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emmanuel Ridge Escorted Transportation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.