MEDICARE: 3JB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	PP412338L	PA
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811992001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	3JB LLC

Provider Business Mailing Address
First Line	:	1207 SECOND STREET
Second Line	:
City	:	CRESSON
State	:	PA
Zip	:	16630-1147
Country	:	US
Telephone Number	:	721-744-3300
Fax Number	:	724-744-2351

Provider Business Practice Location Address
First Line	:	2106 ROUTE 130
Second Line	:
City	:	HARRISON CITY
State	:	PA
Zip	:	15636-1516
Country	:	US
Telephone Number	:	724-744-3300
Fax Number	:	724-744-2351

Authorized Official
Title or Position	:	CFO
Name	:	MR. STEVEN J DECRISCIO
Credential	:
Telephone Number	:	814-408-6800

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	06/08/2022

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Directions to “3JB LLC ” Practice Location

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