14 LAWRENCE AVE PHARMACY — OIG Excluded Provider (SMITHTOWN, NY, 1128a1)
14 LAWRENCE AVE PHARMACY — OIG Excluded Provider (SMITHTOWN, NY, 1128a1) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: 14 LAWRENCE AVE PHARMACY; Type: Entity; Provider category: PHARMACY.
| Name | 14 LAWRENCE AVE PHARMACY |
|---|---|
| Type | Entity |
| Provider category | PHARMACY |
| City | SMITHTOWN |
| State | NY |
| ZIP | 11787 |
| Exclusion authority | 1128a1 |
| Exclusion reason | Conviction of program-related crimes |
| Exclusion date | 1988-08-30 |
| Source | HHS-OIG LEIE |
$1499/mo
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