Jac Stores INC
Durable Medical Equipment & Medical Supplies in Flora, IL. Organization (NPI-2).
NPI number1578747184
StatusActive
Last updated in NPPESFeb 13, 2013
Details
- NPI
- 1578747184
- Entity type
- Organization (NPI-2)
- Legal business name
- Jac Stores INC
- Organization subpart
- No
- Enumeration date
- Dec 19, 2007
- Last updated
- Feb 13, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | 054016343 | IL | Yes |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Sav Mor Pharmacy (Doing Business As)
Practice location
121 W North AveFlora, IL 62839-1613
Phone 618-662-9470
Mailing address
2245 W Mound RdDecatur, IL 62526-9367
Phone 217-362-6226 · Fax 217-362-6241
Authorized official
David Falk
Owner Pres
2172626226
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