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General NPI Number Information
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NPI Number | 1861565582
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Entity Type | Organization
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Legal Business Name | 3JB LLC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 317 BEAVER ST
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City | HASTINGS
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State | PA
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Zip | 16646-0520
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Country | US
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Telephone | 814-247-9959
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Fax | 814-247-8690
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Provider Business Mailing Address
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Address Line | PO BOX 598
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City | HASTINGS
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State | PA
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Zip | 16646-0598
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Country | US
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Telephone | 814-247-9959
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Fax | 814-274-8690
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Authorized Official
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Title or Position | CFO
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Name | STEVEN JOSEPH DECRISCIO
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Credential |
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Telephone | 814-408-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP411885L
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License Number State | PA
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