Provider Demographics
NPI:1710231147
Name:GUTTENBERG MUNICIPAL HOSPITAL
Entity Type:Organization
Organization Name:GUTTENBERG MUNICIPAL HOSPITAL
Other - Org Name:CORNERSTONE FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-252-2141
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:IA
Mailing Address - Zip Code:52052-0550
Mailing Address - Country:US
Mailing Address - Phone:563-252-1121
Mailing Address - Fax:563-252-3120
Practice Address - Street 1:200 MAIN STREET
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:IA
Practice Address - Zip Code:52052-0550
Practice Address - Country:US
Practice Address - Phone:563-252-2141
Practice Address - Fax:563-252-9013
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUTTENBERG MUNICIPAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty