Jacks Pharmacy Inc
Community/Retail Pharmacy
103 E College Ave, St Maries
Idaho, 83861-2247
208-245-4578 208-245-5004
Jacks Pharmacy Inc is a Community/Retail Pharmacy in St Maries, Idaho. It is located at 103 E College Ave, St Maries and it's customer support contact number is 208-245-4578. The authorized person of Jacks Pharmacy Inc is Dr. Colt Darley who is Pharmacist/president of the pharmacy and his contact number is 208-245-4578. Active license number of Jacks Pharmacy Inc is 1368CP for Community/Retail Pharmacy in Idaho. Jacks Pharmacy Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Jacks Pharmacy Inc is 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.
Pharmacy Details:
Jacks Pharmacy Inc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Jacks Pharmacy Inc |
| Type: | Community/Retail Pharmacy |
| Location: | 103 E College Ave, St Maries,
Idaho, 83861-2247 |
| Phone: | 208-245-4578 |
| Fax: | 208-245-5004 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Colt Darley |
| Position: | Pharmacist/president |
| Contact Number: | 208-245-4578 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1518967710 |
| NPI Enumeration Date: | 28 Jul, 2005 |
| NPI Last Update On: | 07 Feb, 2020 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jacks Pharmacy Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 1368CP | Idaho | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 002494400 | Medicaid | Idaho | |
| 002494500 | Medicaid | Idaho | |
| 1303483 | Other | Idaho | Ncpdp |
Medicare Enrollment:
Jacks Pharmacy Inc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 5991822280 | O20170912002779 | Jacks Pharmacy Inc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 103 E College Ave,
St Maries, Idaho |
| Zip: | 83861-2247 |
| Phone Number: | 208-245-4578 |
| Fax Number: | 208-245-5004 |
Patients can reach Jacks Pharmacy Inc at
103 E College Ave, St Maries, Idaho or can
call on customer care at 208-245-4578.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.