TIDALHEALTH PENINSULA REGIONAL, INC.; NPI #1255153680

Contact Information

TIDALHEALTH PENINSULA REGIONAL, INC.

200 EAST VINE ST
SALISBURY, MD 21801

Phone: 410-543-4798
Fax: 410-543-4799
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Clinic Pharmacy	3336C0002X	58	Medical Supply Company with Pharmacist

Indicates primary specialty

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NPI Profile & details for TIDALHEALTH PENINSULA REGIONAL, INC.

NPI Number	`1255153680`
LBN Legal business name	TIDALHEALTH PENINSULA REGIONAL, INC.
Authorized official	WILLIAM COOPER - (DIRECTOR OF AMBULATORY PHARMACY)
Entity	Organization
Organization subpart ¹	Yes
Enumeration date	10/28/2024
Last updated	10/28/2024 - More than a year 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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