Jac Stores INC
NPI #1245777911 in Cerro Gordo, Illinois
Provider Information
- NPI Number
- 1245777911
- Entity Type
- Organization
- Organization Name
- Jac Stores INC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jan 19, 2017
- Last Updated
- Apr 8, 2022
Practice Location
- Address
- 407 S JACKSON ST
- City
- Cerro Gordo
- State
- Illinois
- ZIP Code
- 61818-4360
- Phone
- (217) 763-6161
Authorized Official
- Name
- DAVID FALK
- Title
- OWNER
- Phone
- (217) 362-6226
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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