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General NPI Number Information
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NPI Number | 1154365062
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Entity Type | Organization
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Legal Business Name | ST ELIZABETH MEDICAL CENTER, INC
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 4900 HOUSTON RD
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City | FLORENCE
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State | KY
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Zip | 41042
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Country | US
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Telephone | 859-212-5200
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Fax | 859-578-5980
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Provider Business Mailing Address
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Address Line | 1 MEDICAL VILLAGE DR
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City | EDGEWOOD
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State | KY
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Zip | 41017-3403
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Country | US
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Telephone | 859-655-1889
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Fax | 859-578-5980
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Authorized Official
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Title or Position | CFO (INTERIM)
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Name | LORI RITCHEY-BALDWIN
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Credential |
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Telephone | 859-655-0109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 100273
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 100273
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License Number State | KY
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