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
11101 CATHAGE RD, BERLIN, MD 21811
(410) 543-4769
(410) 543-4770
Mailing address
11101 CATHAGE RD, BERLIN, MD 21811-2115
(410) 543-4769
(410) 543-4770
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P06935
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153648
PK
—
Enumeration date
10/17/2014
Last updated
03/02/2026
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