# DECATUR MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PHYSICIAN'S PLAZA PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609879097
- **Authorized official:** STEVEN WELCH RPH (PHRMCY MGR)
- **Authorized official phone:** (217) 876-6252

## Contact information

- **Practice address:** 2300 N EDWARD ST, DECATUR, IL 62526-4163
- **Practice address phone:** (217) 876-6252
- **Practice address fax:** (217) 876-6215
- **Mailing address:** 2300 N EDWARD ST, DECATUR, IL 62526-4163
- **Mailing address phone:** (217) 876-6252
- **Mailing address fax:** (217) 876-6215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054011351 | IL | Yes |

## Other

- **Enumeration date:** 05/31/2005
- **Last updated:** 05/23/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2017369 | PK | — |