Organization
TIDALHEALTH PENINSULA REGIONAL, INC.
Active
Other names
TidalHealth Family Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICKEY M GRIFFIN CRCE (DIRECTOR, PFS)
(410) 543-7437
Entity
Organization
Contact information
Practice address
100 E CARROLL ST, SALISBURY, MD 21801-5422
(410) 543-7437
(410) 543-7020
Mailing address
PO BOX 2498, SALISBURY, MD 21802-2498
(410) 543-7437
(410) 543-7020
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
22-003
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401428600
—
MD
Enumeration date
02/27/2009
Last updated
11/16/2020
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