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Organization

JAC STORES INC

Active
Other names
Bertram Pharmacy LTC
Organization subpart
No

Provider details

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

Contact information

Practice address
1300 N ALLEN ST, ROBINSON, IL 62454-1090
(217) 433-6226
(618) 544-9298
Mailing address
2245 W MOUND RD, DECATUR, IL 62526-9367
(217) 362-6226
(217) 362-6241

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Enumeration date
06/26/2024
Last updated
06/26/2024
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