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RRC140135-09 Decatur Memorial Hospital (Active)
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Main Details
Name
Decatur Memorial Hospital
Subdivision Name
DMH Lung Center
Type
Rural Referral Center
Rural
No
340B ID
RRC140135-09
Medicare Provider Number
140135
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/26/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/13/2017
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Decatur Memorial Hospital
Drew Early, President CEO
(217) 876-2114
Primary Contact
Decatur Memorial Hospital
Paul William Robinson, 340B Coordinator
(217) 876-2031
Addresses
Street Address
302 W Hay St, Ste. 110
Decatur, IL 62526-4167
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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