Provider Demographics
NPI:1104911221
Name:MEDICAL ANALYSIS
Entity type:Organization
Organization Name:MEDICAL ANALYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PITALO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:228-432-7071
Mailing Address - Street 1:1025 DIVISION ST.
Mailing Address - Street 2:SUITE E
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530
Mailing Address - Country:US
Mailing Address - Phone:228-385-2550
Mailing Address - Fax:228-432-7071
Practice Address - Street 1:250 BEAUVOIR RD # B
Practice Address - Street 2:SUITE 5
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4026
Practice Address - Country:US
Practice Address - Phone:228-385-2550
Practice Address - Fax:228-388-9861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS059723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy