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
—
—
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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