MATHEW, REX
Debarred entityUnited States. Named in 5 sanctions listings.
Summary
License number: PROMISe# 101299576`
Sanctions and listings5
- Effective
- 18 Sep 2019
Official designation
New York State Office of the Medicaid Inspector GeneralUS New York State Medicaid ExclusionsUnited States
- Effective
- 2 Jan 2017
Official designation
US Delaware Medicaid Sanctioned ProvidersUnited States
TERMINATION Disqualified in PA effective 1/2/16, in New Jersey effective 01/02/2017, in MD effective 4/4/18, and NY 9/18/19 Office of the State Comptroller Medicaid Fraud Unit.
- Effective
- 2 Jan 2016
Official designation
Department of Human ServicesUS Pennsylvania Medicheck listUnited StatesPrecluded
- Effective
- 4 Apr 2018
Official designation
New Jersey Office of the State ComptrollerUS New Jersey Ineligible Medicaid ProvidersUnited States
DISQUALIFICATION
- Effective
- 2 Jan 2017
Official designation
New Jersey Office of the State ComptrollerUS New Jersey Ineligible Medicaid ProvidersUnited States
DISQUALIFICATION
Identifiers3
| Identifier | Number |
|---|---|
| ID number | 00274821 |
| ID number | MD422922 |
| NPI number | 1336164862 |
Other names2
Also known as2
Addresses4
2301 SOUTH BROAD STREET, PHILADELPHIA, PA 19148
(NJ), (NJ)
17608 PRINCE EDWARD DRIVE, OLNEY, MD 20832
NJ, NJ
United States
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