Dales Southlake Pharmacy

Community/Retail Pharmacy Accepts Medicare


  
  245 W 1st Dr Ste B, Decatur
Illinois, 62521-5381

 217-429-5165    217-429-5172
Dales Southlake Pharmacy is a Community/Retail Pharmacy in Decatur, Illinois. This pharmacy is owned and operated by Lake Of Decatur Inc. It is located at 245 W 1st Dr Ste B, Decatur and it's customer support contact number is 217-429-5165. The authorized person of Dales Southlake Pharmacy is Dale Colee who is President of the pharmacy and his contact number is 217-429-5165. Active license number of Dales Southlake Pharmacy is 54.015385 for Community/Retail Pharmacy in Illinois. Dales Southlake Pharmacy accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Dales Southlake Pharmacy is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.


Pharmacy Details:
Dales Southlake Pharmacy type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
Name: Dales Southlake Pharmacy
Type: Community/Retail Pharmacy
Location:245 W 1st Dr Ste B, Decatur,
Illinois, 62521-5381
Phone:217-429-5165
Fax:217-429-5172
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
Name: Dale Colee
Position: President
Contact Number: 217-429-5165
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
NPI Number: 1588613384
NPI Enumeration Date: 09 May, 2006
NPI Last Update On: 21 Oct, 2021

Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dales Southlake Pharmacy are as mentioned below.
SpecializationLicense NumberStateStatus
Community/Retail Pharmacy 54.015385IllinoisPrimary
Pharmacy Secondary
Long Term Care Pharmacy Secondary
Managed Care Organization Pharmacy Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
IdentifierTypeStateIssuer
2021672OtherPk
Medicare Enrollment:
Dales Southlake Pharmacy is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
PAC ID: Enrollment ID: Org NameMedicare Entity Type
9830309954O20100930058238Lake Of Decatur IncDME SUPPLIER - PHARMACY
9830309954O20131114001965Lake Of Decatur IncPART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY)
Products Available:
Dales Southlake Pharmacy has following products available for sale under medicare.
    Products
  • Blood Glucose Monitors & Supplies: Non-mail Order
  • Business Mailing Address:
    Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
    Address: 245 W 1st Dr Ste B,
    Decatur, Illinois
    Zip: 62521-5381
    Phone Number: 217-429-5165
    Fax Number: 217-429-5172
    Patients can reach Dales Southlake Pharmacy at 245 W 1st Dr Ste B, Decatur, Illinois or can call on customer care at 217-429-5165.

    Comments/ Reviews:


    *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.

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