Provider Demographics
NPI:1417696527
Name:VETERANS MEMORIAL HOSPITAL CITY OF WAUKON IA
Entity Type:Organization
Organization Name:VETERANS MEMORIAL HOSPITAL CITY OF WAUKON IA
Other - Org Name:VMH MEDICAL CLINIC POSTVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:563-568-3411
Mailing Address - Street 1:PO BOX 567
Mailing Address - Street 2:
Mailing Address - City:POSTVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52162-0567
Mailing Address - Country:US
Mailing Address - Phone:563-568-3411
Mailing Address - Fax:563-568-3411
Practice Address - Street 1:124 W GREENE ST
Practice Address - Street 2:
Practice Address - City:POSTVILLE
Practice Address - State:IA
Practice Address - Zip Code:52162
Practice Address - Country:US
Practice Address - Phone:563-864-7221
Practice Address - Fax:563-864-7224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VETERANS MEMORIAL HOSPITAL CITY OF WAUKON IA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center