NPIMap

Organization Active NPI

Jac Stores Inc

Doing business as Sav Mor Pharmacy Nokomis LTC

  • Long Term Care Pharmacy
  • Nokomis, IL
National Provider Identifier
1396530838
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
JAC STORES INC
Doing business as
Sav Mor Pharmacy Nokomis LTC
Practice address
110 E State St
Nokomis, IL 62075-1340
Phone
(217) 563-8346
Fax
(217) 563-2418
NPI assigned
Apr 14, 2025
Last updated
Apr 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
JAC STORES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

110 E State St
Nokomis, IL 62075-1340

Mailing address

2245 W Mound Rd
Decatur, IL 62526-9367
Phone (217) 433-6226

Other names 1

  • Sav Mor Pharmacy Nokomis LTC 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
Part of
J a C Stores Inc

Other organizations with this tax ID 14

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

View all 14

Locations

110 E State St
Nokomis, IL 62075
Phone (217) 563-8346

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1396530838",
    "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": "217-433-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E STATE ST",
            "city": "NOKOMIS",
            "state": "IL",
            "postal_code": "620751340",
            "telephone_number": "217-563-8346",
            "fax_number": "217-563-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAC STORES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAC STORES INC",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "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": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sav Mor Pharmacy Nokomis LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nokomis, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.