Provider Demographics
NPI:1295099141
Name:VIRGINIA GAY HOSPITAL, INC.
Entity type:Organization
Organization Name:VIRGINIA GAY HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIEGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-472-6200
Mailing Address - Street 1:401 CARDINAL AVE
Mailing Address - Street 2:
Mailing Address - City:ATKINS
Mailing Address - State:IA
Mailing Address - Zip Code:52206-4700
Mailing Address - Country:US
Mailing Address - Phone:319-446-7800
Mailing Address - Fax:319-446-7814
Practice Address - Street 1:401 CARDINAL AVE
Practice Address - Street 2:
Practice Address - City:ATKINS
Practice Address - State:IA
Practice Address - Zip Code:52206-4700
Practice Address - Country:US
Practice Address - Phone:319-446-7800
Practice Address - Fax:319-446-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-26
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty