Provider Demographics
NPI:1255112074
Name:DECATUR HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:DECATUR HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION CFO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-401-8770
Mailing Address - Street 1:609 MEDICAL CENTER DR STE 1100
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3840
Mailing Address - Country:US
Mailing Address - Phone:940-626-2555
Mailing Address - Fax:
Practice Address - Street 1:609 MEDICAL CENTER DR STE 1100
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3840
Practice Address - Country:US
Practice Address - Phone:940-626-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DECATUR HEALTH SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy