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Debarred entityUnited States. Named in 1 sanctions listing.
Summary
License number: 2006204640 A300000834
Sanctions and listings1
- Effective
- 16 Jan 2018; 28 Sep 2022
- Ended
- 28 Sep 2027
Official designation
Delaware Secretary of State; Pennsylvania Department of Human ServicesUS Delaware Medicaid Sanctioned ProvidersUnited States
Active-Pharmacy-Medicaid Crossover-CSR suspended 1 year
Identifiers1
| Identifier | Number |
|---|---|
| NPI number | 1407962665 |
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