Provider Demographics
NPI:1326590852
Name:ST ELIZABETH MEDICAL CENTER INC
Entity Type:Organization
Organization Name:ST ELIZABETH MEDICAL CENTER INC
Other - Org Name:ST ELIZABETH HEALTHCARE GRANT SWING BED
Other - Org Type:Other Name
Authorized Official - Title/Position:SR 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:
Mailing Address - Fax:
Practice Address - Street 1:238 BARNES RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:KY
Practice Address - Zip Code:41097-9482
Practice Address - Country:US
Practice Address - Phone:859-655-1889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit