Healthcare Provider Details

I. General information

NPI: 1104827732
Provider Name (Legal Business Name): VIRGINIA GAY HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 N 9TH AVE
VINTON IA
52349-2254
US

IV. Provider business mailing address

502 N 9TH AVE
VINTON IA
52349-2254
US

V. Phone/Fax

Practice location:
  • Phone: 319-472-6360
  • Fax: 319-472-5976
Mailing address:
  • Phone: 319-472-6360
  • Fax: 319-472-5976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateIA

VIII. Authorized Official

Name: MICHAEL J RIEGE
Title or Position: CEO
Credential:
Phone: 319-472-6260