Organization
DECATUR MEMORIAL HOSPITAL
Active
Other names
DMH Medical Equipment Co.
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA FAHEY (COO)
(217) 876-2119
Entity
Organization
Contact information
Practice address
2875 N WATER ST, DECATUR, IL 62526-4233
(217) 876-4040
(217) 876-4075
Mailing address
3122 BRETTWOOD CIR, SUITE B, DECATUR, IL 62526-2425
(217) 876-4040
(217) 876-4075
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5870764
BLUE CROSS BLUE SHEILD
IL
Enumeration date
02/27/2007
Last updated
05/13/2019
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