<Unavail>

LBN: Jac Stores Inc
<Unavail> is an health care organization with primary practice located at 1110 N Topper Dr , Mount Pulaski IL 62548-1401. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Jac Stores Inc can be contacted via phone (217) 362-6226, or through Falk, David via phone (217) 362-6226.

Contact Information

Primary practice address
1110 N Topper Dr Mount Pulaski IL 62548-1401
Phone: (217) 362-6226
Fax: (217) 792-5635
Website:
Map and Directions
Authorized official contact:
Name: Falk, David
Phone: (217) 362-6226

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 054020026 Illinois

Profile Details

NPI number 1316393374
LBN Legal business name Jac Stores Inc
DBA Doing business as <Unavail>
Authorized official Falk, David
Entity Organization
Organization subpart 1 No
Enumeration date May 9th, 2016
Last updated Oct 12th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1316393374 NPPES
Other 2159739 PK

Popular Providers