Healthcare Provider Details

I. General information

NPI: 1578187209
Provider Name (Legal Business Name): ST. ELIZABETH MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL VILLAGE DR.
EDGEWOOD KY
41017
US

IV. Provider business mailing address

1 MEDICAL VILLAGE DR.
EDGEWOOD KY
41017
US

V. Phone/Fax

Practice location:
  • Phone: 859-301-4510
  • Fax: 859-301-4927
Mailing address:
  • Phone: 859-301-4510
  • Fax: 859-301-4927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LORI RITCHEY
Title or Position: EXCECUTIVE VICE PRESIDENT CFO
Credential:
Phone: 859-655-1642