MEDICARE: JESS LET IT SIMMER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	174200000X	Meals Provider
2	332U00000X	Home Delivered Meals
3	335G00000X	Medical Foods Supplier
4	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1437931649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESS LET IT SIMMER

Provider Business Mailing Address
First Line	:	8322 PINEVILLE MATTHEWS RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-4707
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8322 PINEVILLE MATTHEWS RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-4707
Country	:	US
Telephone Number	:	205-720-3646
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA OWENS
Credential	:
Telephone Number	:	205-720-3646

Provider Enumeration Date	:	10/23/2023
Last Update Date	:	10/23/2023

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Directions to “JESS LET IT SIMMER ” Practice Location

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