| Walmart Health | |
|
3615 Charles Hardy Pkwy Ste 200 Dallas GA 30157-9472 | |
| (770) 863-7200 | |
| Not Available |
| Full Name | Walmart Health |
|---|---|
| Speciality | General Practice |
| Location | 3615 Charles Hardy Pkwy Ste 200, Dallas, Georgia |
| Authorized Official Name and Position | Mark Shen (OWNER) |
| Authorized Official Contact | 5127797276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walmart Health 6910 E Chauncey Ln Ste 220 Phoenix AZ 85054-5162 Ph: (480) 247-3366 | Walmart Health 3615 Charles Hardy Pkwy Ste 200 Dallas GA 30157-9472 Ph: (770) 863-7200 |
| NPI Number | 1174264337 |
|---|---|
| Provider Enumeration Date | 04/04/2022 |
| Last Update Date | 10/20/2023 |
| Certification Date | 10/18/2023 |
| Medicare PECOS PAC ID | 4183955974 |
|---|---|
| Medicare Enrollment ID | O20240311000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174264337 | NPI | - | NPPES |
| Provider Name | Dana M Hasten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174653638 PECOS PAC ID: 4880592260 Enrollment ID: I20060201000192 |
| Provider Name | Arthur Rothstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477803393 PECOS PAC ID: 2062656101 Enrollment ID: I20130911000760 |
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