Organization
ST ELIZABETH MEDICAL CENTER, INC
Active
Other names
St Elizabeth Grant Reference Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN VANLANINGHAM (CFO & TREASURER)
(859) 655-1642
Entity
Organization
Contact information
Practice address
238 BARNES RD, WILLIAMSTOWN, KY 41097
(859) 824-8240
(859) 655-1773
Mailing address
401 E 20TH ST, COVINGTON, KY 41014
(859) 655-1821
(859) 655-1773
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000063670
ANTHEM REF LAB
KY
01
—
0512774
AETNA
—
Enumeration date
05/21/2008
Last updated
06/23/2011
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