Provider Demographics
NPI:1578261673
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:<UNAVAIL>
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:703-522-2727
Mailing Address - Fax:
Practice Address - Street 1:3500 BOSTON ST STE J2
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-5251
Practice Address - Country:US
Practice Address - Phone:410-522-0001
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:2023-02-17
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care