Organization
ST ELIZABETH MEDICAL CENTER, INC
Active
Other names
St Elizabeth Edgewood Reference Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
LORI RITCHEY-BALDWIN (CFO)
(859) 655-1642
Entity
Organization
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017
(859) 301-2170
(859) 655-1773
Mailing address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 655-1889
(859) 655-1773
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000061933
ANTHEM REF LAB
KY
01
—
0059383
AETNA
—
01
—
0474136
AETNA
—
Enumeration date
05/21/2008
Last updated
03/21/2019
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