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NPI Code Detail

MEDICARE: JLM IMAGING LLC

MEDICARE: JLM IMAGING LLC
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
1335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging Supplier

General Provider Information

NPI Number : 1851001291
Entity Type Code : Organization
Provider Name (Legal Business Name) : JLM IMAGING LLC
Provider Business Mailing Address
First Line : 2123 CIVIC CENTER DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-6327
Country : US
Telephone Number : 702-333-0110
Fax Number :
Provider Business Practice Location Address
First Line : 2123 CIVIC CENTER DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-6327
Country : US
Telephone Number : 702-333-0110
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JIMMY MATHIS
Credential :
Telephone Number : 702-333-0110
Provider Enumeration Date : 11/28/2022
Last Update Date : 11/28/2022

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