OrganizationActive
Jackisch Drug Store, LLC
NPI 1790289163 · Community/Retail Pharmacy · Pagosa Springs, CA
Jackisch Drug Store, LLC is a Community/Retail Pharmacy organization in Pagosa Springs, CA (NPI 1790289163).
Provider details
- NPI number
- 1790289163
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Todd Antrobus, Owner(606) 316-2031
Specialties & taxonomies
Suppliers
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
426 Pagosa Street
Pagosa Springs, CA 81147
Phone: (970) 264-4166
Street-level locationGet directions
Mailing address
115 Mills St
Olive Hill, KY 41164-6800
Registry dates
- Enumerated
- 2018-03-21
- Last updated
- 2018-03-21
Frequently asked questions
- What is Jackisch Drug Store, LLC's NPI number?
- Jackisch Drug Store, LLC's National Provider Identifier (NPI) is 1790289163, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jackisch Drug Store, LLC?
- Jackisch Drug Store, LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Jackisch Drug Store, LLC located?
- Jackisch Drug Store, LLC's practice location on file with NPPES is 426 Pagosa Street, Pagosa Springs, CA 81147.
- What is Jackisch Drug Store, LLC's phone number?
- The practice phone number listed in the NPPES registry for Jackisch Drug Store, LLC is (970) 264-4166.
- Who is the authorized official for Jackisch Drug Store, LLC?
- The authorized official listed on Jackisch Drug Store, LLC's NPPES record is Todd Antrobus, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jackisch Drug Store, LLC's NPI active?
- Yes — Jackisch Drug Store, LLC's NPI (1790289163) is active in the NPPES registry as of the last update on 2018-03-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.