Organization
3JB LLC
Active
Other names
MAINLINE PHARMACY HASTINGS
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN JOSEPH DECRISCIO (CFO)
(814) 408-6800
Entity
Organization
Contact information
Practice address
317 BEAVER ST, HASTINGS, PA 16646-0520
(814) 247-9959
(814) 247-8690
Mailing address
PO BOX 598, HASTINGS, PA 16646-0598
(814) 247-9959
(814) 274-8690
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP411885L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103037188-0005
—
PA
Enumeration date
11/17/2006
Last updated
06/08/2022
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