NPIMap

Organization Active NPI

St Elizabeth Outpatient Pharmacy

  • General Acute Care Hospital
  • Edgewood, KY
National Provider Identifier
1932250842
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
PO6507 Issued in KS
Legal business name
ST ELIZABETH OUTPATIENT PHARMACY
Practice address
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone
(859) 301-5348
Fax
(859) 301-5344
NPI assigned
Jan 16, 2007
Last updated
Jun 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Authorized official

Name
Tom L Ware, RPH
Title
Pic
Phone
(859) 301-5348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X PO6507 KS Primary

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017-3403

Mailing address

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-5348

Other identifiers 1

IdentifierTypeStateIssuer
54000591MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
St Elizabeth Grant Coun26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1932250842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-5348",
            "fax_number": "859-301-5344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-5348",
            "fax_number": "859-301-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ELIZABETH OUTPATIENT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "859-301-5348",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "KS",
            "license": "PO6507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54000591",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.