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St. Elizabeth Medical Center, Inc.

Organization Active NPI Specialty Pharmacy · Edgewood, KY

NPI 1366084337 · NPPES record last updated Oct 11, 2019

Key facts

NPI
1366084337
Entity type
Organization (NPI type 2)
Primary specialty
Specialty Pharmacy 3336S0011X
Legal business name
ST. ELIZABETH MEDICAL CENTER, INC.
Practice address
850 Thomas More Parkway
Edgewood, KY 41017
Phone
(859) 301-4525
NPI assigned
Oct 11, 2019
Organization subpart
Yes
Parent organization (as reported)
ST. ELIZABETH MEDICAL CENTER, INC.

Authorized official

Name
Gary Blank
Title
Evp/Coo
Phone
(859) 301-2370

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 25

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 187

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 187

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. Elizabeth Dearborn Hospital
Lawrenceburg, IN · CCN 150086		 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2020
St. Elizabeth Ft. Thomas - SNF
Fort Thomas, KY · CCN 185328		 Skilled nursing facility Adp of the SNF Dec 31, 2024
St Elizabeth Healthcare
Edgewood, KY · CCN 185394		 Skilled nursing facility Adp of the SNF Jan 16, 2019
St. Elizabeth Home Care
Florence, KY · CCN 187075		 Home health agency 5% Or Greater Direct Ownership Interest (50%) Dec 3, 2007
St Elizabeth Home Care Services
Lawrenceburg, IN · CCN 157055		 Home health agency 5% Or Greater Direct Ownership Interest (50%) Oct 9, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200511000676 KY DME Supplier - Pharmacy 0648174623 Practice locations: Edgewood, KY

National Provider Directory

Tax ID family
Charles Stephens MD (26 organizations share this tax ID)
Part of
Charles Stephens MD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X
Mail Order Pharmacy 3336M0002X
Specialty Pharmacy 3336S0011X Yes

Addresses

Primary practice location

850 Thomas More Parkway
Edgewood, KY 41017

Mailing address

20 Medical Village Drive
Edgewood, KY 41017
Phone (859) 301-9025

Other providers in Edgewood, KY

All providers in Edgewood, KY · Specialty Pharmacy in Kentucky

Sources for this page

Verify at the official NPI Registry.