NPIMap

Organization Active NPI

Jac Stores Inc

  • Community/Retail Pharmacy
  • Louisville, IL
National Provider Identifier
1316307994
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054019675 Issued in IL
Legal business name
JAC STORES INC
Doing business as
Sav Mor Pharmacy
Practice address
326 Route 45 N
Louisville, IL 62858-2652
Phone
(618) 665-4828
Fax
(618) 665-4814
NPI assigned
Feb 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054019675 IL Primary

Addresses

Primary practice location

326 Route 45 N
Louisville, IL 62858-2652

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2157611OtherPK

Other names 1

  • Sav Mor Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sav Mor Drug15 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

Locations

326 Route 45 N
Louisville, IL 62858
Phone (618) 665-4828

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1316307994",
    "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": "326 ROUTE 45 N",
            "city": "LOUISVILLE",
            "state": "IL",
            "postal_code": "628582652",
            "telephone_number": "618-665-4828",
            "fax_number": "618-665-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAC STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-25",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/AO",
        "authorized_official_telephone_number": "217-362-6226"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054019675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157611",
            "state": null
        }
    ],
    "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 Louisville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.