WALMART CARE CLINIC 10-0658 - NPI 1174930150 - General Practice in Rome, GA

Q: What is Mc Medical LLC's NPI number?

The NPI number for Mc Medical LLC is 1174930150. It was assigned to this organization in the NPPES registry on July 22, 2014. The provider is also known as Walmart Care Clinic 10-0658.

Q: What is Mc Medical LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Mc Medical LLC was last updated on December 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Walmart Care Clinic 10-0658 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALMART CARE CLINIC 10-0658 (NPI 1174930150) is a healthcare organization registered as a general practice in Rome, Georgia and active in the NPI registry since July 2014. The organization lists Soujanya Pulluru, President, as its authorized official.

NPPES Registry Identity

NPI1174930150

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameMC MEDICAL LLC

Location Address2510 REDMOND CIR NWRome, GA 30165-1913

Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 204-8550

Phone(706) 728-3246

Fax(706) 232-6598

Organization SubpartNo

Authorized OfficialSoujanya PulluruPresident · (706) 728-3246

Enumeration DateJuly 22, 2014

Last NPPES UpdateDecember 7, 20212 updates tracked since enumeration

NPPES CertifiedDecember 7, 2021

✔ NPI 1174930150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedNurse PractitionerTaxonomy 363L00000X

2510 REDMOND CIR NW, Rome, GA 30165

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Other Names 1

Other NameWalmart Care Clinic 10-0658

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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