Organization
MC MEDICAL LLC
Active
Other names
Walmart Care Clinic 10-0658
Organization subpart
No
Provider details
NPI number
Authorized official
SOUJANYA PULLURU (PRESIDENT)
(706) 728-3246
Entity
Organization
Contact information
Practice address
2510 REDMOND CIR NW, ROME, GA 30165-1913
(706) 728-3246
(706) 232-6598
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/22/2014
Last updated
12/07/2021
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