NPI 1881948305
Jac Stores INC
Practice location
- Address
- 59 Cedar Sq, Clinton, IL 61727-2201
- Phone
- (217) 935-0315
- Fax
- (217) 935-0319
- Mailing address
- 2245 W Mound Rd, Decatur, IL 62526-9367
Authorised official
- Name
- David Falk
- Title
- President/Owner
- Phone
- (217) 362-6226
Registered specialties (3)
Community/Retail Pharmacy
Primary
Durable Medical Equipment & Medical Supplies
Pharmacy
Registry record
- NPI
- 1881948305
- Entity type
- Organization
- NPI issued
- 6 Nov 2012
- Record last updated
- 22 Feb 2013
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.