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JACKS PHARMACY INC
NPI 1619001187
Durable Medical Equipment & Medical Supplies in St Maries, ID

Active since March 15, 2007
103 E COLLEGE AVE, ST MARIES, ID 83861(208) 245-4578(208) 245-5004 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacks Pharmacy Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKS PHARMACY INC (NPI 1619001187) is a healthcare organization registered as a durable medical equipment & medical supplies in St Maries, Idaho and active in the NPI registry since March 2007. The organization lists Colt Darley, Pharmacist/president, as its authorized official.

NPPES Registry Identity

NPI1619001187
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameJACKS PHARMACY INC
Location Address103 E COLLEGE AVESt Maries, ID 83861-2247
Mailing Address103 E College AveSt Maries, ID 83861-2247 · (208) 245-4578 · Fax (208) 245-5004
Phone(208) 245-4578
Fax(208) 245-5004
Organization SubpartNo
Authorized OfficialColt DarleyPharmacist/president · (208) 245-4578
Enumeration DateMarch 15, 2007
Last NPPES UpdateApril 23, 2025
NPPES CertifiedApril 23, 2025
✔ NPI 1619001187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
License✔ Licensed in ID · 1368CP
Definition
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.
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
103 E COLLEGE AVE, St Maries, ID 83861
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Other Identifiers 3

Other1303483ID · Ncpdp
Medicaid002494500ID
Medicaid002494400ID

Medical Equipment Supplier Medicare DMEPOS 8

Medicare supplier enrollment and the product categories Jacks Pharmacy carries, from the Medicare DMEPOS supplier directory.

Jacks Pharmacy

DMEPOS supplier · Saint Maries, IDOperated by Jacks Pharmacy Inc
✔

Accepts Medicare assignment

Jacks Pharmacy agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)34357946
Medicare Participant SinceAugust 1, 2017
Supplier Location103 E College AveSaint Maries, ID 83861
Phone(208) 245-4578
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Heat & Cold Applications
Heat therapy, Cold therapy, Heating pads
Canes and/or Crutches
Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFREY ALAN BASH PHARM-D
Pharmacist
103 E COLLEGE AVE
ST MARIES, ID 83861
Benewah County (208) 245-4578
DR. BROOK ALLISON KOTLARZ PHARMD
Pharmacist
103 E COLLEGE AVE
ST MARIES, ID 83861
Benewah County (208) 245-4578
DR. DI ANN BUTTERFIELD PHARMD
Pharmacist
103 E COLLEGE AVE
ST MARIES, ID 83861
Benewah County (208) 245-4578
JACKS PHARMACY INC
Pharmacy (Community/Retail Pharmacy)
103 E COLLEGE AVE
ST MARIES, ID 83861
Benewah County (208) 245-4578

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacks Pharmacy Inc's NPI number?

The NPI number for Jacks Pharmacy Inc is 1619001187. It was assigned to this organization in the NPPES registry on March 15, 2007.

Where is Jacks Pharmacy Inc located?

Jacks Pharmacy Inc is located at 103 E College Ave, St Maries, ID 83861. The listed phone number is (208) 245-4578.

What is Jacks Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Jacks Pharmacy Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Jacks Pharmacy accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

When was this NPI record last updated?

The NPPES record for Jacks Pharmacy Inc was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.