NPIMap

Organization Active NPI

St. Elizabeth Medical Center, Inc

Doing business as The Saint Elizabeth Medical Village Pharmacy

  • Pharmacy
  • Edgewood, KY
National Provider Identifier
1902960487
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
ST. ELIZABETH MEDICAL CENTER, INC
Doing business as
The Saint Elizabeth Medical Village Pharmacy
Practice address
20 Medical Village Dr
Edgewood, KY 41017-5401
Phone
(859) 301-9025
Fax
(859) 301-9028
NPI assigned
Dec 20, 2006
Last updated
Nov 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lori Ritchey-Baldwin
Title
Cfo
Phone
(859) 655-1642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X KY Primary

Addresses

Primary practice location

20 Medical Village Dr
Edgewood, KY 41017-5401

Mailing address

20 Medical Village Dr
Edgewood, KY 41017-5401
Phone (859) 301-9025

Other identifiers 1

IdentifierTypeStateIssuer
54001912MedicaidKY

Other names 1

  • The Saint Elizabeth Medical Village Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201005000865 KY Part B Supplier - Mass Immunization (Roster Biller Only) 0648174623 Practice locations: Edgewood, KY

Other NPIs with the same Medicare PAC ID 14

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

View all 14

National Provider Directory

National Provider Directory

Locations

20 Medical Village Dr
Edgewood, KY 41017
Phone (859) 344-1600

20 Medical Village Dr
Ste 101
Edgewood, KY 41017
Phone (859) 301-9025

Ownership & related parties

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 HospitalLawrenceburg, IN, CCN 150086 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2020
St. Elizabeth Ft. Thomas - SNFFort Thomas, KY, CCN 185328 Skilled nursing facility Adp of the SNF Dec 31, 2024
St Elizabeth HealthcareEdgewood, KY, CCN 185394 Skilled nursing facility Adp of the SNF Jan 16, 2019
St. Elizabeth Home CareFlorence, KY, CCN 187075 Home health agency 5% Or Greater Direct Ownership Interest (50%) Dec 3, 2007
St Elizabeth Home Care ServicesLawrenceburg, IN, CCN 157055 Home health agency 5% Or Greater Direct Ownership Interest (50%) Oct 9, 2020

Owned or controlled facilities with NPI records 5

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1902960487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175401",
            "telephone_number": "859-301-9025",
            "fax_number": "859-301-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175401",
            "telephone_number": "859-301-9025",
            "fax_number": "859-301-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ELIZABETH MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "RITCHEY-BALDWIN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "859-655-1642"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54001912",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Saint Elizabeth Medical Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.