Organization
TIDALHEALTH PENINSULA REGIONAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE RITCHIE (CFO FINANCE VICE PRESIDENT)
(410) 543-7298
Entity
Organization
Contact information
Practice address
MCCREADY HEALTH PAVILION, 201 HALL HWY, CRISFIELD, MD 21817-1237
(410) 543-7733
Mailing address
100 E CARROLL ST, SALISBURY, MD 21801-5422
(410) 546-6400
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000325501
—
MD
Enumeration date
03/18/2021
Last updated
03/18/2021
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