Provider Demographics
NPI:1255226049
Name:HALLSTEAD FAMILY PHARMACY LLC
Entity type:Organization
Organization Name:HALLSTEAD FAMILY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:JURASKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-853-3159
Mailing Address - Street 1:36 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:HALLSTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:18822-8874
Mailing Address - Country:US
Mailing Address - Phone:570-879-9553
Mailing Address - Fax:
Practice Address - Street 1:36 ROSE ST
Practice Address - Street 2:
Practice Address - City:HALLSTEAD
Practice Address - State:PA
Practice Address - Zip Code:18822-8874
Practice Address - Country:US
Practice Address - Phone:570-879-9553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HALLSTEAD FAMILY PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy