Healthcare Provider Details

I. General information

NPI: 1265234850
Provider Name (Legal Business Name): JMJC INFUSION CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

749 SAINT MICHAELS DR
BOWIE MD
20721-1959
US

IV. Provider business mailing address

749 SAINT MICHAELS DR
BOWIE MD
20721-1959
US

V. Phone/Fax

Practice location:
  • Phone: 240-548-7173
  • Fax:
Mailing address:
  • Phone: 240-548-7173
  • Fax: 240-255-3064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARIA LEO
Title or Position: NP
Credential: NP
Phone: 240-548-7173