MEDICARE: JLJ MEDICAL LIMITED LIABILTY COMPANY, PRIORITY CARE CLINICS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1568295525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JLJ MEDICAL LIMITED LIABILTY COMPANY, PRIORITY CARE CLINICS

Provider Business Mailing Address
First Line	:	217 E CHURCHVILLE RD
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21014-3825
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3720 WASHINGTON BLVD STE A
Second Line	:
City	:	HALETHORPE
State	:	MD
Zip	:	21227-1659
Country	:	US
Telephone Number	:	410-646-0001
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALER
Name	:	MARY MARTELLONI
Credential	:
Telephone Number	:	410-698-2665

Provider Enumeration Date	:	08/23/2024
Last Update Date	:	09/26/2024

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