TIDALHEALTH ATLANTIC, INC; NPI #1700472321

Contact Information

TIDALHEALTH ATLANTIC, INC

9733 HEALTHWAY DR
BERLIN, MD 21811-1155

Phone: 410-641-9241
Fax: 410-641-9246
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 ATLANTIC, INC

NPI #	`1700472321`
LBN Legal business name	TIDALHEALTH ATLANTIC, INC
Authorized official	STEPHANIE GARY - (SVP, FINANCE/CFO OF TIDALHEALTH)
Entity	Organization
Organization subpart ¹	No
Enumeration date	12/17/2020
Last updated	03/11/2026 - About 3 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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