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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Jack Levine | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Jack | [sources] | |||
| Last name | Levine | [sources] | |||
| NPI | 1164492922 | [sources] | |||
| Address | 7428 State Route 772, Piketon, OH 45661 | [sources] | |||
| Last change | Last processed | First seen | |||
Medicaid providers sanctioned in West Virginia's Medicaid program.
United States · MMIS
us-medwv-f44d9aec15c834c6966efef7e1bf7a4e6676a371 · us-npi-1164492922For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | Medicaid Management Information System | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| 7428 State Route 772, Piketon, OH 45661 | United States | |