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General NPI Number Information
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NPI Number | 1164477725
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Entity Type | Organization
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Legal Business Name | DECATUR MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 2300 N EDWARD ST GSBLL
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City | DECATUR
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State | IL
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Zip | 62526-4163
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Country | US
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Telephone | 217-876-2868
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Fax | 217-876-2874
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Provider Business Mailing Address
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Address Line | 2300 N EDWARD ST
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City | DECATUR
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State | IL
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Zip | 62526-4163
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Country | US
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Telephone | 217-876-2857
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Fax | 217-876-6485
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Authorized Official
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Title or Position | CEO
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Name | DREW EARLY
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Credential |
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Telephone | 217-876-2114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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