Healthcare Provider Details

I. General information

NPI: 1437826989
Provider Name (Legal Business Name): COASTAL FAMILY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7312 HWY 63 N
MOSS POINT MS
39563
US

IV. Provider business mailing address

9113 HIGHWAY 49 STE 200
GULFPORT MS
39503-4330
US

V. Phone/Fax

Practice location:
  • Phone: 228-374-2476
  • Fax:
Mailing address:
  • Phone: 228-374-2476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK HUTTO
Title or Position: DIRECTOR OF PHARMACY SERVICES
Credential: PHARMD
Phone: 228-374-2476