| Organization Name: | JESSCO LLC |
| NPI Number: | 1033290499 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUDITH LEE GALUARDI (ADMINISTRATOR) |
| Mailing Address: | 10308 Old Ocean City Blvd Berlin |
| State: | MD US |
| Postal Code: | 218111132 |
| Phone Number: | 4106419886 |
| Fax Number: | 4106411746 |
| NPI Enumeration Date: | 10/18/2006 |
| NPI Last Update Date: | 10/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | PENDING |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |