# JCMG ANCILLARY SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841261153
- **Authorized official:** CASSIE CALL (CREDENTIALING)
- **Authorized official phone:** (573) 556-1783

## Contact information

- **Practice address:** 1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
- **Practice address phone:** (573) 635-5264
- **Practice address fax:** (573) 636-9756
- **Mailing address:** 1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
- **Mailing address phone:** (573) 635-5264
- **Mailing address fax:** (573) 636-9756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | 0980220 | MO | Yes |
| 291U00000X | Clinical Medical Laboratory | 26D0446044 | MO | — |
| 333600000X | Pharmacy | 006386 | MO | — |

## Other

- **Enumeration date:** 01/27/2006
- **Last updated:** 10/30/2023