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Organization
TIDALHEALTH NANTICOKE, INC
Active
Organization
TIDALHEALTH NANTICOKE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GARY (VICE PRESIDENT-FINANCE/ CFO)
(410) 912-6059
Entity
Organization
Contact information
Practice address
801 MIDDLEFORD RD, SEAFORD, DE 19973-3636
(302) 629-6611
(302) 628-6363
Mailing address
801 MIDDLEFORD RD, SEAFORD, DE 19973-3636
(302) 629-6611
(302) 628-6363
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
282N00000X
General Acute Care Hospital
Primary
HSPTL008
DE
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000067105
—
DE
05
—
000067506
—
DE
Enumeration date
12/01/2005
Last updated
11/21/2024
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