All Medicaid billing entities listing SANDOVAL, BRANDON (OWNER) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Oregon | 1 | $667.05 |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | DRUG MART PHARMACY INC | LA PINE, OR | Compounding Pharmacy | $667.05 |