Organization
MC MEDICAL LLC
Active
Other names
Walmart Health
Organization subpart
No
Provider details
NPI number
Authorized official
SOUJANYA PULLURU (OWNER)
(630) 545-4046
Entity
Organization
Contact information
Practice address
7745 GALL BLVD, ZEPHYRHILLS, FL 33541
(813) 364-5945
Mailing address
702 SW 8TH ST # MS 0445, BENTONVILLE, AR 72716-0445
(479) 258-2080
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/29/2022
Last updated
11/29/2022
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