Organization
3JB LLC
Active
Other names
Mainline Pharmacy Harrison City
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN J DECRISCIO (CFO)
(814) 408-6800
Entity
Organization
Contact information
Practice address
2106 ROUTE 130, HARRISON CITY, PA 15636-1516
(724) 744-3300
(724) 744-2351
Mailing address
1207 SECOND STREET, CRESSON, PA 16630-1147
(721) 744-3300
(724) 744-2351
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PP412338L
PA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103037188-0004
—
PA
Enumeration date
06/15/2005
Last updated
06/08/2022
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