Organization
TIDALHEALTH PENINSULA REGIONAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICKEY GRIFFIN CRCE (SENIOR DIRECTOR PFS)
(410) 543-7437
Entity
Organization
Contact information
Practice address
100 E CARROLL ST, FINANCE DEPT., SALISBURY, MD 21801-5422
(410) 543-7437
(410) 543-7020
Mailing address
100 E CARROLL ST, FINANCE DEPT., SALISBURY, MD 21801-5422
(410) 543-7437
(410) 543-7020
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
22003
MD
291U00000X
Clinical Medical Laboratory
21D0221168
MD
Other
Enumeration date
09/21/2006
Last updated
11/16/2020
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