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General NPI Number Information
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NPI Number | 1962460428
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Entity Type | Organization
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Legal Business Name | JSM ENTERPRISES, LLC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 450 N NEW BALLAS RD STE. 250
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6835
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Country | US
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Telephone | 314-567-4449
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Fax | 314-567-0762
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Provider Business Mailing Address
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Address Line | PO BOX 796002
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City | SAINT LOUIS
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State | MO
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Zip | 63179-6000
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Country | US
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Telephone | 314-567-4449
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Fax | 314-567-0762
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHARON MODICA
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Credential |
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Telephone | 314-567-5445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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