NPI: 1225142318 · DAVIDSVILLE, PA 15928 · Pharmacy · NPI assigned 08/18/2006
| Authorized Official | DECRISCIO, STEVEN (CFO) |
| NPI Enumeration Date | 08/18/2006 |
Other providers sharing the same authorized official: DECRISCIO, STEVEN
| Provider | City | State | Total Paid |
|---|---|---|---|
| 3JB LLC | BLAIRSVILLE | PA | $15K |
| 3JB LLC | HARRISON CITY | PA | $5K |
| MAINLINE CPL, LLC | CRESSON | PA | $2K |
| MAINLINE PHARMACY EBENSBURG, LLC | NANTY GLO | PA | $2K |
| MAINLINE PHARMACY EBENSBURG LLC | EBENSBURG | PA | $2K |
| 3JB LLC | SOMERSET | PA | $963.94 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 82 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0011A | 82 | 82 | $3K |