TIDALHEALTH SPECIALTY CARE, LLC; NPI #1063374114

Contact Information

TIDALHEALTH SPECIALTY CARE, LLC

10231 OLD OCEAN CITY BLVD STE 104
BERLIN, MD 21811-3567

Phone: 410-629-6863
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Wound Care	163WW0000X

Indicates primary specialty

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NPI Profile & details for TIDALHEALTH SPECIALTY CARE, LLC

NPI Number	`1063374114`
LBN Legal business name	TIDALHEALTH SPECIALTY CARE, LLC
Authorized official	SLOAN TRAMMELL - (CREDENTIALING MANAGER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	11/26/2025
Last updated	11/26/2025 - About 6 months ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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TIDALHEALTH SPECIALTY CARE, LLC

Contact Information

Specialty

Wound Care

NPI Profile & details for TIDALHEALTH SPECIALTY CARE, LLC

Reviews for TIDALHEALTH SPECIALTY CARE, LLC