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DSH180035Z ST ELIZABETH HEALTHCARE (Terminated)
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Main Details
Name
ST ELIZABETH HEALTHCARE
Subdivision Name
Hospice Unit
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180035Z
Medicare Provider Number
180035
Outpatient Facility Provider Number
181513
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/24/2016
Last Recertification Date
9/9/2020
Termination Date
Termination Reason
10/1/2021
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
St. Elizabeth Healthcare
Lori Ritchey-Baldwin, CFO
(859) 655-1642
Primary Contact
St. Elizabeth Healthcare
Joe Thamann, Director of Reimbursement
(859) 655-1889
Addresses
Street Address
483 South Loop Rd.
Edgewood, KY 41017
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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