Organization
TIDALHEALTH PENINSULA REGIONAL, INC.
Active
Parent organization
TIDALHEALTH PENINSULA REGIONAL, INC.
Other names
TidalHealth Specialty Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
TIDALHEALTH PENINSULA REGIONAL, INC.
Authorized official
JOHN JORDAN (SR. DIRECTOR OF PHARMACY)
(410) 749-2825
Entity
Organization
Contact information
Practice address
100 E. CARROLL STREET, SUITE 1435A, SALISBURY, MD 21801
(667) 330-1065
(410) 438-1992
Mailing address
1620 W. NORTHWEST HWY, SUITE 100, GRAPEVINE, TX 76051
(817) 572-0009
(817) 572-0221
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
02/02/2017
Last updated
12/02/2025
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