Lake Of Decatur Inc is an authorized DME supplier for medicare equipments and products.
Lake Of Decatur Inc is a Community/Retail Pharmacy in Decatur, Illinois. 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 Lake Of Decatur Inc is Dale Colee who is President of the pharmacy and his contact number is 217-429-5165. Active license number of Lake Of Decatur Inc is 54.015385 for Community/Retail Pharmacy in Illinois. Lake Of Decatur Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance. Lake Of Decatur Inc 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:
Lake Of Decatur Inc 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:
Lake Of Decatur Inc
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 Lake Of Decatur Inc are as mentioned below.
Specialization
License Number
State
Status
Community/Retail Pharmacy
54.015385
Illinois
Primary
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.
Identifier
Type
State
Issuer
2021672
Other
Pk
Medicare Enrollment:
Lake Of Decatur Inc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
PAC ID:
Enrollment ID:
Org Name
Medicare Entity Type
9830309954
O20100930058238
Lake Of Decatur Inc
DME SUPPLIER - PHARMACY
9830309954
O20131114001965
Lake Of Decatur Inc
PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY)
Products Available:
Lake Of Decatur Inc 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 Lake Of Decatur Inc 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 10 March, 2025.
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