Organization
MC MEDICAL LLC
Active
Other names
Walmart Health
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD HENRY (ENROLLMENT MANAGER)
(479) 258-2080
Entity
Organization
Contact information
Practice address
6100 W RENO AVE STE C, OKLAHOMA CITY, OK 73127-6507
(479) 258-2080
Mailing address
702 SW 8TH ST # MS 0445, BENTONVILLE, AR 72716-6209
(479) 258-2080
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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