Person
Screen this subjectShane Danielson
Debarred entityUnited States. Named in 2 sanctions listings.
Summary
License number: PROMISe#102389195
Sanctions and listings2
- Effective
- 1 Mar 2018
Official designation
Department of Human ServicesUS Pennsylvania Medicheck listUnited StatesPrecluded
- Effective
- 1 Mar 2018
Official designation
Pennsylvania Department of Human servicesUS Delaware Medicaid Sanctioned ProvidersUnited States
TERMINATION Reporting Only-Active PA. Terminated Provider Agreement
Identifiers2
| Identifier | Number |
|---|---|
| ID number | MD424844 |
| NPI number | 1780706812 |
Addresses1
Montgomery, PA
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