# MC MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Walmart Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306253521
- **Authorized official:** SOUJANYA PULLURU (PRESIDENT)
- **Authorized official phone:** (706) 225-5681

## Contact information

- **Practice address:** 5448 WHITTLESEY BLVD, STE B, COLUMBUS, GA 31909-7298
- **Practice address phone:** (706) 225-5681
- **Practice address fax:** (706) 321-7118
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 204-8550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/21/2014
- **Last updated:** 11/22/2022