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Maravich Enterprises dba Hidden Valley Pharmacy

Debarred entity

Maravich Enterprises dba Hidden Valley Pharmacy is an entity of interest. It has not been found on international sanctions lists.

Type	Company				[sources]
Name	Maravich Enterprises dba Hidden Valley Pharmacy				[sources]
Incorporation date	not available				[sources]
Jurisdiction	not available				[sources]
Country	United States				[sources]
NPI	`1790116861` · `1790806602`				[sources]
Registration number	`PHY050997` · `PHY51432`				[sources]
Sector	Entity/Corporation				[sources]
Address	19851 Hartmann Rd., Unit C, Hidden Valley Lake, CA, 95467				[sources]
Last change	2024-12-12	Last processed	2026-02-15	First seen	2024-11-07

Sanctions
Country	Authority	Program	Start date	End date
United States	Department of Health Care Services		2020-02-12	-

Linked to
Object	Role	Start date	End date
Hidden Valley Pharmacy Debarred entity	-	-	-

Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.

United States · DHCS

Source data IDs: us-npi-1790806602 · us-npi-1790116861 · us-medca-e4739d2f7f8a88c913a25097f3ded9d04e37d095

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