Provider Demographics
NPI:1447083506
Name:JLJ MEDICAL LIMITED LIABILTY COMPANY, PRIORITY CARE CLINICS
Entity type:Organization
Organization Name:JLJ MEDICAL LIMITED LIABILTY COMPANY, PRIORITY CARE CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTELLONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-698-2665
Mailing Address - Street 1:217 E CHURCHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3825
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5282 CAMPBELL BLVD STE I
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4913
Practice Address - Country:US
Practice Address - Phone:410-933-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JLJ MEDICAL LIMITED LIABILTY COMPANY, PRIORITY CARE CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care