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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | JOHN DAVID ZACHARIAH WALLACE · Wallace, John David Zachariah | [sources] | |||
| Birth date | [sources] | ||||
| Nationality | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| First name | JOHN | [sources] | |||
| Last name | WALLACE | [sources] | |||
| Middle name | DAVID ZACHARIAH | [sources] | |||
| NPI | 1679900161 | [sources] | |||
| Sector | Employee - Private Sector Bus - Mental/Behavioral Health FAC | [sources] | |||
| Position | MENTAL/BEHAVIORAL HE (EMPLOYEE - PRIVATE S) | [sources] | |||
| Address | Butner, NC 27509 · P O BOX 1000, #34986-171, BUTNER, NC 27509 | [sources] | |||
| Last change | Last processed | First seen | |||
| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States of America | Department of Health and Human Services Office of Inspector General | List of Excluded Individuals/Entities (LEIE) | - | ||
| United States of America | South Carolina Department of Health and Human Services | - | - | ||
People and companies excluded from Federally funded health care programs
United States of America · OIG
Medical providers excluded from South Carolina's Medicaid program.
United States of America · SCDHHS
us-medsc-e2f00c80ccadf85ee0ce2c75983d57c0dbfd1943 · us-fed-excl-john-david-zachariah-wallace-27509-butnerFor experts: raw data explorer
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