Provider Demographics
NPI:1952306508
Name:MEDICAL ARTS PHARMACY, INC
Entity Type:Organization
Organization Name:MEDICAL ARTS PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:727-821-4765
Mailing Address - Street 1:459 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-2803
Mailing Address - Country:US
Mailing Address - Phone:727-821-4765
Mailing Address - Fax:727-363-1011
Practice Address - Street 1:459 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-2803
Practice Address - Country:US
Practice Address - Phone:727-821-4765
Practice Address - Fax:727-363-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22:00124332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies