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Jac Stores Inc

Jac Stores Inc is a health care provider in Decatur, IL. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 110 E State St, Nokomis, IL 62075-1340, US
Practice Location Phone217-563-8346
Practice Location Fax217-563-2418
Legal Business NameJAC STORES INC
Other Organization NameSAV MOR PHARMACY
Other Organization Name TypeDoing Business As Name
NPI ?1366453862
Entity TypeOrganization
Enumeration Date ? Aug 10, 2006
Last Update Date ? Jul 11, 2016
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Jac Stores Inc

SpecialtySpecializationLicenseLicense State
Pharmacy
PharmacyCommunity/Retail Pharmacy 054006164Illinois

legacy-id-icon Legacy Provider IDs of Jac Stores Inc

Provider IdIssuer StateIssuer TypeIssuer
2017269OtherPK
=========004IllinoisMedicaid

official-icon Authorized Official of Jac Stores Inc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Jac Stores Inc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official David Falk
Authorized Official Title/PositionPRESIDENT & OWNER
Authorized Official Phone Number217-362-6226