Prost Data Inc

Debarred entity

United States. Named in 6 sanctions listings.

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Summary

License number: PROMISe #100906848

KMAP Provider Number 200265200A (Nashville); 200265200C (Mitten)

Sanctions and listings6

Effective
1 Sep 2017
Official designation
Pennsylvania Department of Human servicesUS Delaware Medicaid Sanctioned ProvidersUnited States
TERMINATION Termination of provider agreement if no response by 09/01/2017
medicaid.dhss.delaware.gov
Effective
25 Nov 2013
Official designation
Michigan Department of Health & Human ServicesUS Michigan Medicaid Sanctioned Provider ListUnited States
Suspended/debarred from state of TN
michigan.gov
Effective
23 Mar 2017
Official designation
Department of Human ServicesUS Pennsylvania Medicheck listUnited StatesPrecluded
pa.gov
Effective
29 Nov 2013
Official designation
Kansas Department of Health and EnvironmentUS Kansas Medicaid Terminated Provider ListUnited States
KMAP denied revalidation specific to the NPIs listed.
kdhe.ks.gov
Effective
30 Jun 2014
Official designation
Washington State Health Care AuthorityUS Washington State Provider Termination and Exclusion ListUnited States
Terminated by CMS
hca.wa.gov
Effective
4 Oct 2014
Official designation
South Carolina Department of Health and Human ServicesUS South Carolina Excluded ProvidersUnited StatesTerminated for cause
scdhhs.gov

Identifiers5

Identifier	Number
ID number	NPI 1760461909
NPI number	1386873693
NPI number	1760461909
NPI number	1881983336
Tax number	731508813

Other names6

Also known as6

Out LabOur Lab/Endo Lab/Mod LabProst Data, Inc.Prost DataProst Data, IncOurLab

Addresses4

Nashville, TN, MI
Nashville, TN 37210
(TN), (TN)
TN, TN
United States

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