Mc Medical LLC
General Practice in Jacksonville, FL. Organization (NPI-2).
NPI number1841900982
StatusActive
Last updated in NPPESNov 30, 2022
Details
- NPI
- 1841900982
- Entity type
- Organization (NPI-2)
- Legal business name
- Mc Medical LLC
- Organization subpart
- No
- Enumeration date
- Nov 30, 2022
- Certification date
- Nov 23, 2022
- Last updated
- Nov 30, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
| 363L00000X | Nurse Practitioner | – | – |
Other names
- Walmart Health (Doing Business As)
Practice location
10991 San Jose Blvd Unit 100Jacksonville, FL 32223-6675
Phone 904-380-3055
Mailing address
702 Sw 8th St # Ms 0445Bentonville, AR 72716-0445
Phone 479-258-2080
Authorized official
Soujanya Pulluru
Owner
6305454046
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