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RRC140135-46 Decatur Memorial Hospital (Active)
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Main Details
Name
Decatur Memorial Hospital
Subdivision Name
DMH Surgery Center - Surgery
Type
Rural Referral Center
Rural
No
340B ID
RRC140135-46
Medicare Provider Number
140135
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/3/2022
Participating Start Date
4/1/2022
Participating Approval Date
2/14/2022
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
304 W. Hay St., Ste 114
Decatur, IL 62526
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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