Healthcare Provider Details

I. General information

NPI: 1205877024
Provider Name (Legal Business Name): VIRGINIA GAY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 08/22/2020
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 Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL J RIEGE
Title or Position: ADMINISTRATOR
Credential:
Phone: 319-472-6200