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Organization

TIDALHEALTH PENINSULA REGIONAL, INC.

Active
Other names
TIdalHealth Home Scripts, TidalHealth Community Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN J JOHNSON (DIRECTOR OF AMBULATORY PHARMACY SVC)
(410) 543-7745
Entity
Organization

Contact information

Practice address
100 E CARROLL ST, SALISBURY, MD 21801-5422
(410) 543-4798
(410) 543-4799
Mailing address
100 E CARROLL ST STE 1492, SALISBURY, MD 21801-5422
(410) 543-4798
(410) 543-4799

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P06040
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2142289
PK
Enumeration date
09/04/2013
Last updated
03/02/2026
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