JAC STORES INC (NPI# 1316393374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316393374 |
| Entity Type | Organization |
| Organization Name | JAC STORES INC |
| Other Organization Name | SAV MOR PHARMACY |
| Practice Address |
1110 N Topper Dr Mount Pulaski IL 62548-1401 |
| Mailing Address |
2245 W Mound Rd Decatur IL 62526-9367 |
| Practice Telephone | 2173626226 |
| Practice Fax Number | 2177925635 |
| Mailing Telephone | 2173626226 |
| Mailing Fax Number | 2173626241 |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2016-10-12 |
| Authorized Official Name | DAVID FALK (OWNER/PRESIDENT/AO) |
| Authorized Official Telephone | 2173626226 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054020026 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2159739 | 01 |
| Other Name | Type Code |
|---|---|
| Sav Mor Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811451594 | Jac Stores Inc | Pharmacy | 34 S Locust St, Pana, IL 62557-1463 | 2019-01-26 |
| 1245777911 | Jac Stores Inc | Pharmacy | 407 S Jackson St, Cerro Gordo, IL 61818-4360 | 2017-01-19 |
| 1316307994 | Jac Stores Inc | Pharmacy | 326 Route 45 N, Louisville, IL 62858-2652 | 2016-02-25 |
| 1699119644 | Jac Stores Inc | Pharmacy | 1410 Village Pkwy, Mt Zion, IL 62549-1253 | 2013-04-22 |
| 1093998551 | Jac Stores Inc | Pharmacy | 121 W North Ave, Flora, IL 62839-1613 | 2007-12-07 |
| 1366453862 | Jac Stores Inc | Pharmacy | 110 E State St, Nokomis, IL 62075-1340 | 2006-08-10 |
| 1326059825 | Jac Stores Inc | Pharmacy | 122 W Locust St, Fairbury, IL 61739-1549 | 2006-08-10 |
| 1285645788 | Jac Stores Inc | Pharmacy | 1300 N Allen St, Robinson, IL 62454-1090 | 2006-08-10 |
| 1417968918 | Jac Stores Inc | Pharmacy | 138 N Market St, Paxton, IL 60957-1220 | 2006-08-10 |
| 1902817406 | Jac Stores Inc | Pharmacy | 105 E Jackson St, Virden, IL 62690-1450 | 2006-08-10 |
| Street Address |
1110 N TOPPER DR |
| City | MOUNT PULASKI |
| State | IL |
| Zip Code | 62548-1401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558462010 | Aussieker Graue Rohrer LLC | Pharmacy | 507 E Chestnut, Mt Pulaski, IL 62548-1008 | 2006-09-26 |
| 1265702799 | Sprinfield Clinic LLP | Clinic/Center | 509 E Chestnut St, Mount Pulaski, IL 62548-1008 | 2011-12-30 |
| 1124678834 | Jill Usherwood | Behavior Technician | 105 Scott Ct, Mount Pulaski, IL 62548-1050 | 2019-09-14 |
| 1992079164 | Sarah Ann Tierney | Counselor | 115 N Washington St, Mount Pulaski, IL 62548-1146 | 2012-03-05 |
| 1164865366 | Lora Lee Erickson | Counselor | 315 N Belmont St, Mount Pulaski, IL 62548-1205 | 2013-04-08 |
| 1538215959 | Bruce E. Mason | Dentist | 117 N Lafayette St, Mount Pulaski, IL 62548-1263 | 2007-01-26 |
| 1518451079 | Kyle Mason | Dentist | 117 N Lafayette St, Mount Pulaski, IL 62548-1263 | 2018-06-19 |
| 1710391222 | Lindsey Mason | Dentist | 117 N Lafayette St, Mount Pulaski, IL 62548-1263 | 2014-06-12 |
| 1457497166 | Drs. Mason & Mason | Clinic/Center | 117 N Lafayette St, Mount Pulaski, IL 62548-1263 | 2007-01-29 |
| 1225184054 | Paul Mason | Dentist | 117 N Lafayette St, Mount Pulaski, IL 62548-1263 | 2007-01-26 |
| Find all providers in zip 62548 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
| 1699389890 | J2sb LLC | Pharmacy | 398 W Army Trail Rd Ste 120, Bloomingdale, IL 60108-2398 | 2020-09-04 |
| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
| 1982212635 | Grand Pharmacy LLC | Pharmacy | 229 W Grand Ave Ste F, Bensenville, IL 60106-3365 | 2020-07-20 |
| 1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
| 1831716745 | The Project of The Quad Cities | Pharmacy | 1701 River Dr Ste 106, Moline, IL 61265-1384 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT PULASKI |
| Zip Code | 62548 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.