MC MEDICAL LLC NPI 1285041434

NPI Information

NPI: 1285041434
Provider Name: MC MEDICAL LLC

Other Name: WALMART CARE CLINIC 10-1153

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
6020 HARRISON RD
MACON, GA
ZIP 31206
Phone: (478) 703-0468
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MC MEDICAL LLC is a general practice in Macon, GA. MC MEDICAL LLC NPI is 1285041434. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Walmart Care Clinic 10-1153.

The provider's business location address is:

6020 HARRISON RD
MACON, GA
ZIP 31206-742
Phone: (478) 703-0468
Fax: (478) 784-9118

The provider's authorized official is Soujanya Pulluru .
The authorized official title is President and has the following contact phone number (479) 703-0468.

The enumeration date for this NPI number is 7/21/2014 and was last updated on 12/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				Yes
2	363L00000X	Nurse Practitioner				No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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