# JAC STORES INC

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

## Provider details

- **NPI number:** 1881948305
- **Authorized official:** DAVID FALK (PRESIDENT/OWNER)
- **Authorized official phone:** (217) 362-6226

## Contact information

- **Practice address:** 59 CEDAR SQ, CLINTON, IL 61727-2201
- **Practice address phone:** (217) 935-0315
- **Practice address fax:** (217) 935-0319
- **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 |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054018054 | IL | Yes |

## Other

- **Enumeration date:** 11/06/2012
- **Last updated:** 02/22/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1487443 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |