Jacks Pharmacy Inc
Durable Medical Equipment & Medical Supplies
103 E College Ave, St Maries
Idaho, 83861-2247
208-245-4578 208-245-5004
Jacks Pharmacy Inc is a Durable Medical Equipment & Medical Supplies 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, PHARMD 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 Durable Medical Equipment & Medical Supplies 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 supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
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: | Durable Medical Equipment & Medical Supplies |
| 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 |
| Credentials: | PHARMD |
| 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: | 1619001187 |
| NPI Enumeration Date: | 15 Mar, 2007 |
| NPI Last Update On: | 23 Apr, 2025 |
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 | |
| Durable Medical Equipment & Medical Supplies | 1368CP | Idaho | Primary | |
| Community/Retail Pharmacy | | | Secondary | |
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 |
| 1303483 | Other | Idaho | Ncpdp |
| 002494500 | Medicaid | Idaho | |
| 002494400 | Medicaid | Idaho | |
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 | O20100930007998 | Jacks Pharmacy Inc | DME SUPPLIER - PHARMACY |
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.