Organization
DECATUR MEMORIAL HOSPITAL
Active
Other names
DMH Medical Equipment Co.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY G PEACOCK (SENIOR VP AND CFO)
(217) 876-4040
Entity
Organization
Contact information
Practice address
102 W KENWOOD AVE, SUITE 100, DECATUR, IL 62526-4368
(217) 876-4040
(217) 876-4084
Mailing address
102 W KENWOOD AVE, SUITE 100, DECATUR, IL 62526-4368
(217) 876-4040
(217) 876-4084
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 SHIELD
IL
Enumeration date
10/06/2006
Last updated
04/02/2009
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