GONZALEZ JORDAN S.
Debarred entityBorn 14 Feb 1980 (46 years old),United States. Named in 5 sanctions listings.
Sanctions and listings5
- Listed
- 29 Sep 2017
- Effective
- 24 Aug 2017
- Effective
- 19 Jan 2017
List of Excluded Individuals/Entities (LEIE)
Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States
1128a4
Programme US-HHS-OIGoig.hhs.govoig.hhs.gov
- Listed
- 20 Jan 2017
- Effective
- 19 Jan 2017
Reciprocal
HHSUS SAM Procurement ExclusionsUnited StatesActive
Prohibition/Restriction
Excluded by the Department of Health and Human Services pursuant to section 1128 or other sections of the Social Security Act from participation in all Federal health care programs (the scope and effect of Federal health care program exclusions is described in 42 C.F.R. section 1001.1901).
- Effective
- 3 Aug 2015
Official designation
New York State Office of the Medicaid Inspector GeneralUS New York State Medicaid ExclusionsUnited States
- Effective
- 9 Feb 2017
Official designation
New Jersey Office of the State ComptrollerUS New Jersey Ineligible Medicaid ProvidersUnited States
DISQUALIFICATION
Positions held1
Period not retained
PHARMACIST (IND- LIC HC SERV PRO)
Identifiers2
| Identifier | Number |
|---|---|
| ID number | 00055480 |
| NPI number | 1992073167 |
Other names2
Also known as2
Addresses3
FAIRTON, NJ 08320
#66214-050, FCI FAIRTON, PO BOX 420, FAIRTON, NJ 08320
P O BOX 420, #66214-050, FAIRTON, NJ 8320
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