Go Live Well Pharmacy LLC

Debarred entity

United States. Named in 5 sanctions listings.

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Summary

State license type / number: Pharmacy / 5018

License number: MO2381

Sanctions and listings5

Effective
28 Nov 2019
Official designation
Medicaid Management Information SystemUS West Virginia Medicaid Provider Exclusions and TerminationsUnited States
Excluded Indefinitely
License terminated by another State Medicaid Agency
wvmmis.com
Effective
28 Nov 2019
Official designation
Kentucky Department for Medicaid ServicesUS Kentucky Terminated and Excluded ProvidersUnited States
Violation of KMAP Policy
chfs.ky.gov
Effective
28 Nov 2019
Official designation
Missouri Medicaid Audit & ComplianceUS Missouri Medicaid Provider TerminationsUnited States
OTHER STATE MEDICAID TERMINATION
mmac.mo.gov
Effective
17 Oct 2019
Official designation
Ohio Department of MedicaidUS Ohio Medicaid Excluded and Suspended ProvidersUnited StatesExcluded
medicaid.ohio.gov
Effective
13 Dec 2021
Official designation
Iowa Health & Human ServicesUS Iowa Medicaid Terminated Provider ListUnited States
Sanction end as published: Indefinite
Termination
441 IAC 79.2(2)(n)
hhs.iowa.gov

Identifiers1

Identifier	Number
NPI number	1649790718

Other names3

Also known as3

GoLive Well PharmacyGo Live Well Phramacy LLCGo Live Well Pharmacy, LLC

Addresses2

13035 Olive Blvd, Ste 210, Creve Coeur, MO 63141
13035 Olive Blvd, Suite 210, Creve Coeur, MO 63141

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