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Organization
JCMG ANCILLARY SERVICES, LLC
Active
Organization
JCMG ANCILLARY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSIE CALL (CREDENTIALING)
(573) 556-1783
Entity
Organization
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
(573) 636-9756
Mailing address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
(573) 636-9756
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
0980220
MO
291U00000X
Clinical Medical Laboratory
26D0446044
MO
333600000X
Pharmacy
006386
MO
Other
Enumeration date
01/27/2006
Last updated
10/30/2023
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