JORDAN BAXTER ANDERSON — OIG Excluded Provider (OMAHA, NE, 1128b4)
JORDAN BAXTER ANDERSON — OIG Excluded Provider (OMAHA, NE, 1128b4) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: JORDAN BAXTER ANDERSON; Type: Individual; Provider category: PHARMACY.
| Name | JORDAN BAXTER ANDERSON |
|---|---|
| Type | Individual |
| Provider category | PHARMACY |
| Specialty | PHARMACIST |
| City | OMAHA |
| State | NE |
| ZIP | 68144 |
| Exclusion authority | 1128b4 |
| Exclusion reason | License revocation, suspension, or surrender |
| Exclusion date | 2002-12-19 |
| Source | HHS-OIG LEIE |
$1499/mo
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