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Blake Boggs

Debarred entity
TypePerson[sources]
NameBlake Boggs[sources]
Birth datenot available[sources]
Nationalitynot available[sources]
CountryUnited States[sources]
First nameBlake[sources]
Last nameBoggs[sources]
NPI1205419181[sources]
Address1599 2nd Avenue, Charleston, WV 25387[sources]
Last changeLast processedFirst seen

Relationships

Sanctions
CountryAuthorityProgramStart dateEnd date
United StatesMedicaid Management Information System--
Address
Full addressCountry
1599 2nd Avenue, Charleston, WV 25387United States

Data sources

US West Virginia Medicaid Provider Exclusions and Terminations329

Medicaid providers sanctioned in West Virginia's Medicaid program.

United States · MMIS


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