NPIMap

Organization Active NPI

Jac Stores Inc

Doing business as Sav Mor Pharmacy

  • Community/Retail Pharmacy
  • Cerro Gordo, IL
National Provider Identifier
1245777911
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
JAC STORES INC
Doing business as
Sav Mor Pharmacy
Practice address
407 S Jackson St
Cerro Gordo, IL 61818-4360
Phone
(217) 763-6161
Fax
(217) 763-6134
NPI assigned
Jan 19, 2017
Last updated
Apr 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Falk
Title
Owner
Phone
(217) 362-6226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X IL Primary

Addresses

Primary practice location

407 S Jackson St
Cerro Gordo, IL 61818-4360

Mailing address

2245 W Mound Rd
Decatur, IL 62526-9367
Phone (217) 362-6226

Other names 1

  • Sav Mor Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
J a C Stores Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1245777911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 W MOUND RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269367",
            "telephone_number": "217-362-6226",
            "fax_number": "217-362-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S JACKSON ST",
            "city": "CERRO GORDO",
            "state": "IL",
            "postal_code": "618184360",
            "telephone_number": "217-763-6161",
            "fax_number": "217-763-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAC STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-362-6226"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sav Mor Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sav Mor Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cerro Gordo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.