Provider Demographics
NPI:1235274226
Name:BTECH INC
Entity Type:Organization
Organization Name:BTECH INC
Other - Org Name:EMMANUEL RIDGE HOSPICE MINISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT,CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:EZEM
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CM, CLNC
Authorized Official - Phone:601-927-9839
Mailing Address - Street 1:2990 HIGHWAY 49 S
Mailing Address - Street 2:SUITE P
Mailing Address - City:FLORENCE
Mailing Address - State:MS
Mailing Address - Zip Code:39073-9522
Mailing Address - Country:US
Mailing Address - Phone:601-845-3544
Mailing Address - Fax:601-845-2095
Practice Address - Street 1:2990 HIGHWAY 49 S
Practice Address - Street 2:SUITE P
Practice Address - City:FLORENCE
Practice Address - State:MS
Practice Address - Zip Code:39073-9522
Practice Address - Country:US
Practice Address - Phone:601-845-3544
Practice Address - Fax:601-845-2095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04036718Medicaid
MS18216OtherPHYSICIAN
MSR772161OtherFNP RN #
MS18216OtherPHYSICIAN
MSH80567Medicare UPIN
MSP58403Medicare UPIN
MSR772161OtherFNP RN #