1588613384 LAKE OF DECATUR INC
Community/Retail Pharmacy
Active
Basic Information
- Organization Name
- LAKE OF DECATUR INC
- Enumeration Date
- May 9, 2006
- Last Update
- October 21, 2021
- Authorized Official
- DALE COLEE
PRESIDENT
Phone: (217) 429-5165
Practice Location
- Address
- 245 W 1ST DR STE B
DECATUR, IL 625215381 - Phone
- (217) 429-5165
- Fax
- (217) 429-5172
Mailing Address
- Address
- 245 W 1ST DR STE B
DECATUR, IL 625215381 - Phone
- (217) 429-5165
- Fax
- (217) 429-5172
Specialties & Taxonomies
| Specialty | Code | Classification | License | State | Primary |
|---|---|---|---|---|---|
| Pharmacy | 333600000X | Pharmacy | N/A | N/A | No |
| Long Term Care Pharmacy Long Term Care Pharmacy | 3336L0003X | Pharmacy | N/A | N/A | No |
| Managed Care Organization Pharmacy Managed Care Organization Pharmacy | 3336M0003X | Pharmacy | N/A | N/A | No |
| Community/Retail Pharmacy Community/Retail Pharmacy | 3336C0003X | Pharmacy | 54.015385 | IL | Primary |
Other Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2021672 | 01 | N/A | PK |
Frequently Asked Questions
What is LAKE OF DECATUR INC's NPI number?
LAKE OF DECATUR INC's NPI number is 1588613384.
Which doctor has NPI number 1588613384?
The doctor with NPI number 1588613384 is LAKE OF DECATUR INC.
What is LAKE OF DECATUR INC's practice address?
LAKE OF DECATUR INC's practice address is 245 W 1ST DR STE B, DECATUR, IL, 625215381.
Which doctor practices at 245 W 1ST DR STE B, DECATUR, IL, 625215381?
LAKE OF DECATUR INC practices at 245 W 1ST DR STE B, DECATUR, IL, 625215381.
What is LAKE OF DECATUR INC's phone number?
LAKE OF DECATUR INC's phone number is (217) 429-5165.
Who is (217) 429-5165?
(217) 429-5165 is the phone number for LAKE OF DECATUR INC.
What is LAKE OF DECATUR INC's specialty?
LAKE OF DECATUR INC's specialty is Community/Retail Pharmacy.
What type of doctor is LAKE OF DECATUR INC?
LAKE OF DECATUR INC is a Community/Retail Pharmacy.
Is LAKE OF DECATUR INC a Community/Retail Pharmacy?
Yes, LAKE OF DECATUR INC is a Community/Retail Pharmacy.
Is LAKE OF DECATUR INC still practicing?
Yes, LAKE OF DECATUR INC is currently practicing.
Is LAKE OF DECATUR INC accepting new patients?
LAKE OF DECATUR INC may be accepting new patients. Please call their office at (217) 429-5165 to inquire about availability.
Is NPI 1588613384 still active?
Yes, NPI 1588613384 is currently active.
Where does LAKE OF DECATUR INC practice?
LAKE OF DECATUR INC practices in DECATUR, IL.