NPI age
19 years
Enumerated 2007-03-15
● Active Type 2 · Organization
Jacks Pharmacy Inc
Jacks Pharmacy Inc is 1 of 264 durable medical equipment & medical supplies organizations in Idaho.
Primary specialty
Durable Medical Equipment & Medical Supplies
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Darley
Pharmacist/president
Last NPPES update
2025-04-23
Source: monthly bulk 2026-05
How this organization compares
Across 264 active durable medical equipment & medical supplies providers in Idaho.
NPI age
19 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 25% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
103 E College Ave
St Maries, ID 838612247
Mailing address
103 E College Ave
St Maries, ID 838612247
Authorized official
Colt Darley, PHARMD
Pharmacist/president
📞 2082454578
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Jeffrey Bash, PHARM-D Pharmacist NPI 1023617883
- Di Ann Butterfield, PHARMD Pharmacist NPI 1396225827
- Brook Kotlarz, PHARMD Pharmacist NPI 1124718051
Specialties
-
Durable Medical Equipment & Medical Supplies PrimaryA 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.
-
PharmacyA 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1303483 | NCPDP |
| 05 (ID) | 002494500 | |
| 05 (ID) | 002494400 |
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
Provyx · Custom healthcare lists
Need all 264 Durable Medical Equipment & Medical Supplies providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.