Provider Demographics
NPI: | 1356813414 |
---|---|
Name: | JEMMS IMAGING SERVICES LLC |
Entity Type: | Organization |
Organization Name: | JEMMS IMAGING SERVICES LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MEMBER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JASON |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MUNIZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 631-949-7824 |
Mailing Address - Street 1: | 103 COOPER ST STE 3 |
Mailing Address - Street 2: | |
Mailing Address - City: | BABYLON |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11702-2368 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 103 COOPER ST STE 3 |
Practice Address - Street 2: | |
Practice Address - City: | BABYLON |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11702-2368 |
Practice Address - Country: | US |
Practice Address - Phone: | 631-539-4853 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-12-28 |
Last Update Date: | 2021-02-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 335V00000X | Suppliers | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | ||
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |