Jac Stores Inc

Community/Retail Pharmacy · Robinson, IL

Organization Active NPI

NPI number 1285645788

Practice location

1300 N Allen St
Robinson, IL 62454-1090
Phone
(618) 544-2167
Fax
(618) 544-9298

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NPI record

NPI
1285645788
Entity type
Organization (Type 2)
Enumeration date
August 10, 2006
Last updated
February 20, 2017
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Community/Retail Pharmacy Primary 3336C0003X 054015383 IL
Pharmacy 333600000X — —

Mailing address

2245 W Mound Rd
Decatur, IL 62526-9367
Phone
(217) 362-6226
Fax
(217) 362-6241

Authorized official

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

Other names

  • Bertram Pharmacy

About Jac Stores Inc

Jac Stores Inc is a healthcare organization registered in the NPI registry with the primary taxonomy Community/Retail Pharmacy (code 3336C0003X). The practice location is 1300 N Allen St, Robinson, IL 62454-1090. The NPI number 1285645788 was assigned on August 10, 2006 and the record was last updated on February 20, 2017.

Jac Stores Inc lists a license in the registry: #054015383 (IL) for Community/Retail Pharmacy. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is David Falk, President & Owner.

Frequently asked questions

What is the NPI number of Jac Stores Inc?

The NPI number is 1285645788.

What is the phone number of Jac Stores Inc?

The phone number listed for the practice location is (618) 544-2167.

Where is Jac Stores Inc located?

1300 N Allen St, Robinson, IL 62454-1090.

What is the taxonomy code for Jac Stores Inc?

The primary taxonomy code is 3336C0003X – Community/Retail Pharmacy; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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