JACKS PHARMACY INC (NPI# 1518967710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518967710 |
| Entity Type | Organization |
| Organization Name | JACKS PHARMACY INC |
| Practice Address |
103 E College Ave St Maries ID 83861-2247 |
| Practice Telephone | 2082454578 |
| Practice Fax Number | 2082455004 |
| Mailing Telephone | 2082454578 |
| Mailing Fax Number | 2082455004 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2020-02-07 |
| Authorized Official Name | DR. COLT DARLEY (PHARMACIST/PRESIDENT) |
| Authorized Official Telephone | 2082454578 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
1368CP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 002494500 | 05 | |
| ID | 002494400 | 05 | |
| ID | NCPDP | 1303483 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619001187 | Jacks Pharmacy Inc | Pharmacy | 103 E College Ave, St Maries, ID 83861-2247 | 2007-03-15 |
| Street Address |
103 E COLLEGE AVE |
| City | ST MARIES |
| State | ID |
| Zip Code | 83861-2247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617883 | Jeffrey Alan Bash | Pharmacist | 103 E College Ave, St Maries, ID 83861-2247 | 2020-10-22 |
| 1396225827 | Di Ann Butterfield | Pharmacist | 103 E College Ave, St Maries, ID 83861-2247 | 2018-08-15 |
| 1124470794 | Colt Darley | Pharmacist | 103 E College Ave, St Maries, ID 83861-2247 | 2016-07-07 |
| 1619001187 | Jacks Pharmacy Inc | Pharmacy | 103 E College Ave, St Maries, ID 83861-2247 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659880789 | Catherine Frances Bean | Private Vehicle | 5753 Alder Creek Rd, St. Maries, ID 83861 | 2017-09-20 |
| 1548320435 | Benewah Community Hospital | General Acute Care Hospital | 229 South 7th St, St Maries, ID 83861 | 2006-12-11 |
| 1881752913 | Richard K Thurston | Emergency Medicine | 229 S 7th Street, St Maries, ID 83861 | 2006-12-04 |
| 1851337208 | Robert D Magwire | Optometrist | 704 College, St Maries, ID 83861 | 2006-06-22 |
| 1205810025 | William Walter Wheeler | Surgery | 229 S. 7th Street, St. Maries, ID 83861 | 2005-12-05 |
| 1952469082 | John Richard Katovich Jr. | Emergency Medicine | 229 S 7th Street, St Maries, ID 83861 | 2006-12-04 |
| 1255351458 | William Scott Spence | Family Medicine | 229 S. 7th Street, St. Maries, ID 83861 | 2006-07-20 |
| 1992756233 | Terry L Spohr | Physician Assistant | 229 S. 7th Street, St. Maries, ID 83861 | 2006-05-12 |
| 1699723411 | David James Luther | Family Medicine | 229 S. 7th Street, Saint Maries, ID 83861 | 2006-05-04 |
| 1629627666 | Valerie Kay Sanchez | Technician/Technologist | 305 N 19th St, St Maries, ID 83861-1156 | 2019-09-11 |
| Find all providers in zip 83861 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619001187 | Jacks Pharmacy Inc | Pharmacy | 103 E College Ave, St Maries, ID 83861-2247 | 2007-03-15 |
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|---|---|---|---|---|
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| 1508420373 | K2red LLC | Pharmacy | 447 N Idaho St, Wendell, ID 83355 | 2019-04-27 |
| 1679039135 | Hollis Family Pharmacy LLC | Pharmacy | 845 S Substation Rd, Emmett, ID 83617 | 2019-02-20 |
| 1598229809 | Clearwater Canyon Pharmacy, LLC | Pharmacy | 13020 Us-12, Orofino, ID 83544 | 2019-01-31 |
| 1861999377 | Bi-mart Corporation | Pharmacy | 11347 W State Street, Star, ID 83669 | 2018-04-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.