Organization
VIRGINIA GAY HOSPITAL, INC
Active
Other names
Urbana Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J RIEGE (ADMINISTRATOR)
(319) 443-5000
Entity
Organization
Contact information
Practice address
1002 W MAIN ST, URBANA, IA 52345-9099
(319) 443-5000
Mailing address
1002 W MAIN ST, URBANA, IA 52345-9099
(319) 443-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5056994
—
IA
Enumeration date
06/13/2006
Last updated
09/22/2016
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