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State of New Jersey
Medicaid Fraud Division
Provider Exclusion Report1**ADDITIONAL NPI NUMBERS MAY BE ASSOCIATED WITH THE LISTED INDIVIDUALS/ENTITIES**
PROVIDER NAME
2258 PHARMACY, INC.
6522 VENT
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How to fill out disqualified providers - state
How to fill out disqualified providers - state
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To fill out disqualified providers - state, follow these steps:
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Access the official state website: Go to the official website of your state's health department or the agency responsible for overseeing disqualified providers.
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What is disqualified providers - state?
Disqualified providers - state refers to individuals or entities who have been banned or excluded from participating in certain state programs or contracts due to various reasons such as fraud, misconduct, or negligence.
Who is required to file disqualified providers - state?
State agencies or organizations responsible for managing government programs or contracts are required to file disqualified providers - state.
How to fill out disqualified providers - state?
Disqualified providers - state can be filled out through an online portal or submission of a specific form provided by the state government.
What is the purpose of disqualified providers - state?
The purpose of disqualified providers - state is to ensure that individuals or entities with a history of misconduct or fraud are not able to participate in government programs or contracts.
What information must be reported on disqualified providers - state?
Information such as the name of the disqualified provider, reason for disqualification, duration of disqualification, and any other relevant details must be reported on disqualified providers - state.
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