Healthcare Provider Details

I. General information

NPI: 1740109446
Provider Name (Legal Business Name): MEDICAL ARTS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 CAILLAVET ST
BILOXI MS
39530-4102
US

IV. Provider business mailing address

120 CAILLAVET ST
BILOXI MS
39530-4102
US

V. Phone/Fax

Practice location:
  • Phone: 228-432-7071
  • Fax: 228-432-7910
Mailing address:
  • Phone: 228-432-7071
  • Fax: 228-432-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: GEORGE PITALO JR.
Title or Position: OWNER
Credential:
Phone: 228-432-7071