3JB LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP412331L Issued in PA

Legal business name

3JB LLC

Doing business as

Mainline Pharmacy - Blairsville

Practice address

315 E Market St
Blairsville, PA 15717-1122

Phone

(724) 459-7400

Fax

(724) 459-8207

NPI assigned

Jul 15, 2006

Last updated

Sep 28, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steven Joseph Decriscio

Title

Cfo

Phone

(814) 408-6800

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Mainline Pharmacy - Blairsville Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• 3JB LLC

  dba Mainline Pharmacy - Davidsville

  • Community/Retail Pharmacy
  • Davidsville, PA
  • NPI 1225142318

  O20170815000999

  Same enrollment
• 3JB LLC

  dba Mainline Pharmacy Harrison City

  • Community/Retail Pharmacy
  • Harrison City, PA
  • NPI 1811992001

  O20170815000999

  Same enrollment
• 3JB LLC

  dba Mainline Pharmacy Hastings

  • Community/Retail Pharmacy
  • Hastings, PA
  • NPI 1861565582

  O20170815000999

  Same enrollment
• SD Pharmacy Services LLC

  dba Mainline Pharmacy - Somerset

  • Community/Retail Pharmacy
  • Somerset, PA
  • NPI 1598771263

  O20170815000999

  Same enrollment

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Pastorek

  • Pharmacist
  • Indiana, PA
  • NPI 1013396167
  NPD (past)
• Gretchen Peirce Semsick, PHARMD, MS

  • Pharmacist
  • Blairsville, PA
  • NPI 1801227186

  Addiction (Substance Use Disorder)

  NPD (past)
• Brian J Sidone, PHARMD

  • Pharmacist
  • Ebensburg, PA
  • NPI 1083990220

  Addiction (Substance Use Disorder)

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1780600114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E MARKET ST",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157171122",
            "telephone_number": "724-459-7400",
            "fax_number": "724-459-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E MARKET ST",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157171122",
            "telephone_number": "724-459-7400",
            "fax_number": "724-459-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3JB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "DECRISCIO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-408-6800"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP412331L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN/NSC",
            "identifier": "7478670001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN/NSC",
            "identifier": "0178510001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154605",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030371880001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mainline Pharmacy - Blairsville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ghada Metwally Ahmed Elsayed, M.D.
• Michelle L. Androstic, O.T.
• Anthony J. Mancuso, OD, LLC
• Brenda Marie Artley, PHARMD
• Lisa C Baker, RPH

• Community/Retail Pharmacy in Blairsville, PA
• Providers in Blairsville, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.