Provider Demographics
NPI:1710160080
Name:ST ELIZABETH MEDICAL CENTER
Entity Type:Organization
Organization Name:ST ELIZABETH MEDICAL CENTER
Other - Org Name:ST ELIZABETH HOLISTIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-301-5959
Mailing Address - Street 1:20 MEDICAL VILLAGE DR
Mailing Address - Street 2:STE 212
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-5401
Mailing Address - Country:US
Mailing Address - Phone:859-301-5959
Mailing Address - Fax:859-301-6162
Practice Address - Street 1:20 MEDICAL VILLAGE DR
Practice Address - Street 2:STE 212
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5401
Practice Address - Country:US
Practice Address - Phone:859-301-5959
Practice Address - Fax:859-301-6162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175L00000XOther Service ProvidersHomeopathGroup - Single Specialty