Organization
ATLANTIC GENERAL HOSPITAL CORP
Active
Other names
Atlantic General Hospital Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GARY (SVP, FINANCE/CFO OF TIDALHEALTH)
(410) 912-6059
Entity
Organization
Contact information
Practice address
9733 HEALTHWAY DR, BERLIN, MD 21811-1155
(410) 641-1100
(410) 641-9219
Mailing address
9733 HEALTHWAY DR, BERLIN, MD 21811-1155
(410) 641-1100
(410) 641-9219
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
21D0869030
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404233600
—
MD
Enumeration date
03/23/2010
Last updated
05/30/2025
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