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Jacks Pharmacy Inc

Community/Retail Pharmacy in St Maries, ID · enumerated 2005 · authorized official Benjamin Potter, Ceo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1518967710

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Registry record

Entity type Organization (Type 2)
Legal business name Jacks Pharmacy Inc
Practice address 103 E College Ave, St Maries, ID, 83861
Phone (208) 245-4578
Fax (208) 245-5004
Enumeration date Jul 28, 2005
Last updated in NPPES Mar 2, 2026

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 1368CP (ID) Primary

Authorized official

Name Benjamin Potter
Title Ceo
Phone (208) 719-9095

Other identifiers

Identifier Type State Issuer
002494400 Medicaid ID —
002494500 Medicaid ID —
1303483 Other ID NCPDP

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty.

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Frequently asked questions

Where is Jacks Pharmacy Inc located?
The practice location on file with NPPES is in St Maries, ID.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2026-03-02. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-03-02.