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Billing entities under JACKULA, SALLY
Every Medicaid billing NPI that lists JACKULA, SALLY (owner) as its authorized official in NPPES: 1 entity in 1 state, paid $174.41 combined.
28Combined paid$174.41
33Billing entities1
24GClaims14
States1
Matched on the name exactly as typed into NPPES. Two different people with the same name will land on the same page.
Box 32 · Location
By state
Box 33 · Billing providers
All entities
| # | Provider | Location | Type | Paid |
|---|---|---|---|---|
| 1 | Iris Vision Care, LLC. | Saint Cloud, MN | Clinic/Center | $174.41 |