NPI: 1629486402 · DEVINE, TX 78016 · Optician · NPI assigned 07/24/2014
| Authorized Official | LEVINE, LAURA (DIR HEALTHCARE CONTRACTING) |
| Parent Organization | WAL-MART STORES, INC |
| NPI Enumeration Date | 07/24/2014 |
Other providers sharing the same authorized official: LEVINE, LAURA
| Provider | City | State | Total Paid |
|---|---|---|---|
| SAMS WEST INC | DENVER | CO | $9K |
| SAMS WEST INC | HONOLULU | HI | $6K |
| SAMS WEST INC | AURORA | CO | $1K |
| SAMS EAST INC | WINSTON SALEM | NC | $715.00 |
| SAMS WEST INC | RENO | NV | $0.00 |
| SAMS EAST INC | METAIRIE | LA | $0.00 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 14 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2025 | Deluxe frame | 14 | 14 | $1K |