USA Pathology and Toxicology
Debarred entityUnited States. Named in 5 sanctions listings.
Summary
KMAP Provider Number 201120960A
Sanctions and listings5
- Effective
- 19 Jan 2017
Official designation
Montana Department of Public Health & Human ServicesUS Montana Medicaid Excluded and Terminated ProvidersUnited States
- Effective
- 28 Sep 2018
Official designation
Louisiana Department of HealthUS Louisiana Department of Health Adverse Actions ListUnited States
42 CFR 455.416
- Effective
- 6 Jul 2017
Official designation
South Carolina Department of Health and Human ServicesUS South Carolina Excluded ProvidersUnited StatesTerminated for cause
- Effective
- 15 Mar 2017
Official designation
Indiana Family and Social Services AdministrationUS Indiana Medicaid Terminated Provider ListUnited States
- Effective
- 29 May 2017
Official designation
Kansas Department of Health and EnvironmentUS Kansas Medicaid Terminated Provider ListUnited States
Medicare billing privileges revoked.
Identifiers1
| Identifier | Number |
|---|---|
| NPI number | 1134526536 |
Other names2
Also known as2
Addresses2
Southfield, MI
Southfield, MI 48075
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