Healthcare Provider Details

I. General information

NPI: 1164486726
Provider Name (Legal Business Name): VIRGINIA GAY HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 02/01/2008
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: 319-472-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number060178H
License Number StateIA

VIII. Authorized Official

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