NPIMap

Organization Active NPI

Decatur Memorial Hospital

Doing business as DMH Medical Equipment Co.

  • Durable Medical Equipment & Medical Supplies
  • Decatur, IL
National Provider Identifier
1437246865
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DECATUR MEMORIAL HOSPITAL
Doing business as
DMH Medical Equipment Co.
Practice address
102 W Kenwood Ave
Suite 100
Decatur, IL 62526-4368
Phone
(217) 876-4040
Fax
(217) 876-4084
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Gary G Peacock
Title
Senior VP and Cfo
Phone
(217) 876-4040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

102 W Kenwood Ave
Suite 100
Decatur, IL 62526-4368

Mailing address

102 W Kenwood Ave
Suite 100
Decatur, IL 62526-4368
Phone (217) 876-4040

Other identifiers 1

IdentifierTypeStateIssuer
5870764OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • DMH Medical Equipment Co. Doing business as

National Provider Directory

National Provider Directory

Locations

2875 N Water St
Decatur, IL 62526
Phone (217) 876-4040

3122 Brettwood Cir
Ste B
Decatur, IL 62526

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1437246865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W KENWOOD AVE",
            "address_2": "SUITE 100",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264368",
            "telephone_number": "217-876-4040",
            "fax_number": "217-876-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W KENWOOD AVE",
            "address_2": "SUITE 100",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264368",
            "telephone_number": "217-876-4040",
            "fax_number": "217-876-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SENIOR VP AND CFO",
        "authorized_official_telephone_number": "217-876-4040",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5870764",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DMH Medical Equipment Co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.