Provider Demographics
NPI:1104699453
Name:ST ELIZABETH MEDICAL CENTER, INC
Entity type:Organization
Organization Name:ST ELIZABETH MEDICAL CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP FINANCE/CFO
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:RITCHEY-BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-655-1642
Mailing Address - Street 1:1 MEDICAL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3403
Mailing Address - Country:US
Mailing Address - Phone:859-655-1604
Mailing Address - Fax:
Practice Address - Street 1:7370 TURFWAY RD STE 150
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-3800
Practice Address - Country:US
Practice Address - Phone:859-212-4450
Practice Address - Fax:859-212-4160
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST ELIZABETH MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-30
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy