# JAC STORES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sav Mor Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316393374
- **Authorized official:** DAVID FALK (OWNER/PRESIDENT/AO)
- **Authorized official phone:** (217) 362-6226

## Contact information

- **Practice address:** 1110 N TOPPER DR, MOUNT PULASKI, IL 62548-1401
- **Practice address phone:** (217) 362-6226
- **Practice address fax:** (217) 792-5635
- **Mailing address:** 2245 W MOUND RD, DECATUR, IL 62526-9367
- **Mailing address phone:** (217) 362-6226
- **Mailing address fax:** (217) 362-6241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054020026 | IL | Yes |

## Other

- **Enumeration date:** 05/09/2016
- **Last updated:** 10/12/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2159739 | PK | — |