Husak Holdings JTL, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410850L Issued in PA

Legal business name

HUSAK HOLDINGS JTL, INC

Practice address

145 E 9TH St
Berwick, PA 18603-3132

Phone

(570) 759-1239

Fax

(570) 759-1230

NPI assigned

Feb 22, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa H Popko, R.PH.NPI 1558957852

Title

President

Phone

(570) 759-1239

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• The Medicine Shoppe Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa H Popko, RPH

  • Pharmacist
  • Berwick, PA
  • NPI 1558957852
  NPD Authorized official

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1992770747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E 9TH ST",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186033132",
            "telephone_number": "570-759-1239",
            "fax_number": "570-759-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E 9TH ST",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186033132",
            "telephone_number": "570-759-1239",
            "fax_number": "570-759-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUSAK HOLDINGS JTL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2023-03-07",
        "certification_date": "2020-12-21",
        "status": "A",
        "authorized_official_last_name": "POPKO",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-759-1239",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "PP410850L",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "PA",
            "license": "RPI000634",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410850L",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "PA",
            "license": "PP4108501",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "3937767",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073970160002",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "0278@medicineshoppe.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "145 E 9th St",
            "city": "Berwick",
            "state": "PA",
            "country_code": "US",
            "postal_code": "186033132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sherri Ann Hoffman, MPH, RD, LDN
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• Community/Retail Pharmacy in Berwick, PA
• Providers in Berwick, 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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.