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Organization
DECATUR MEMORIAL HOSPITAL
Active
Organization
DECATUR MEMORIAL HOSPITAL
Active
Other names
PHYSICIAN'S PLAZA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN WELCH RPH (PHRMCY MGR)
(217) 876-6252
Entity
Organization
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-6252
(217) 876-6215
Mailing address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-6252
(217) 876-6215
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
054011351
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017369
PK
—
Enumeration date
05/31/2005
Last updated
05/23/2013
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