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Organization

JAC STORES INC

Active
Other names
Sav Mor Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID FALK (OWNER/AO)
(217) 362-6226
Entity
Organization

Contact information

Practice address
326 ROUTE 45 N, LOUISVILLE, IL 62858-2652
(618) 665-4828
(618) 665-4814
Mailing address
2245 W MOUND RD, DECATUR, IL 62526-9367
(217) 362-6226
(217) 362-6241

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
054019675
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2157611
PK
Enumeration date
02/25/2016
Last updated
06/02/2022
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