Organization
LAKE OF DECATUR, INC
Active
Other names
Colee's Corner Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
DALE COLEE (OWNER)
(217) 429-5165
Entity
Organization
Contact information
Practice address
845 S ROUTE 51, UNIT B, FORSYTH, IL 62535-9759
(217) 330-9552
(217) 791-6280
Mailing address
845 S ROUTE 51, UNIT B, FORSYTH, IL 62535-9759
(217) 330-9552
(217) 791-6280
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054-018441
IL
3336L0003X
Long Term Care Pharmacy
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Other
Enumeration date
12/12/2013
Last updated
02/20/2020
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