TIDALHEALTH PENINSULA REGIONAL, INC. (NPI# 1285069617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285069617 |
| Entity Type | Organization |
| Organization Name | TIDALHEALTH PENINSULA REGIONAL, INC. |
| Other Organization Name | TIDALHEALTH HOME SCRIPTS |
| Practice Address |
100 E Carroll St Salisbury MD 21801-5422 |
| Practice Telephone | 4105434798 |
| Practice Fax Number | 4105434799 |
| Mailing Telephone | 4105434798 |
| Mailing Fax Number | 4105434799 |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | DENNIS KILLIAN (DIRECTOR OF PHARMACY OPERATION) |
| Authorized Official Telephone | 4105437509 |
| Authorized Official Credential | P.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
P06040 | MD | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2142289 | 01 |
| Other Name | Type Code |
|---|---|
| PRMC Home Scripts | Doing Business As Name - Organization |
| TIdalHealth Home Scripts | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982171005 | Tidalhealth Peninsula Regional, Inc. | General Acute Care Hospital | 106 Milford St Ste 404, Salisbury, MD 21804-6967 | 2018-10-26 |
| 1033592662 | Tidalhealth Peninsula Regional, Inc. | Clinic/Center | 804 Snow Hill Rd, Salisbury, MD 21804-1938 | 2015-07-01 |
| 1851795017 | Tidalhealth Peninsula Regional, Inc. | Pharmacy | 11101 Cathage Rd, Berlin, MD 21811 | 2014-10-17 |
| 1780689463 | Tidalhealth Peninsula Regional, Inc. | Clinical Medical Laboratory | 100 E Carroll St, Salisbury, MD 21801-5422 | 2005-06-17 |
| Street Address |
100 E CARROLL ST |
| City | SALISBURY |
| State | MD |
| Zip Code | 21801-5422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699778811 | Heidi Elizabeth Callahan | Physician Assistant | 100 E Carroll St, # 400, Salisbury, MD 21801-5422 | 2005-05-23 |
| 1649870916 | Katelyn Marie Mcwilliams | Physical Medicine & Rehabilitation | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-10-27 |
| 1356941637 | Kayla Ann Holliday | Physical Medicine & Rehabilitation | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-10-27 |
| 1093315376 | Amanda Strayer | Physical Medicine & Rehabilitation | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-10-27 |
| 1366049876 | Fahad Nayim Md LLC | Skilled Nursing Facility | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-10-07 |
| 1013514157 | Michelle H Grbic | Speech-Language Pathologist | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-10-01 |
| 1568071462 | Anastasiya Deem | Nurse Practitioner | 100 E Carroll St, Salisbury, MD 21801-5493 | 2020-07-27 |
| 1336766021 | Myra Ngambo Njapau-dove | Nurse Anesthetist, Certified Registered | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-29 |
| 1588280655 | Ashton Renee Hyde | Nurse Anesthetist, Certified Registered | 100 E Carroll St, Salisbury, MD 21801-5493 | 2020-06-24 |
| 1952926891 | Tidalhealth Specialty Care, LLC | Pediatrics | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487263760 | Patricia Ann Nativio | Specialist/Technologist | University of Maryland University Eastern Shore, William P Hytche Athletic Center, Princess Anne, MD 21801 | 2020-07-23 |
| 1710516315 | Launa Duffy | Counselor | 1300 East Carroll St, Salisbury, MD 21801 | 2020-04-06 |
| 1275161960 | Zion Wellness Center | Psychiatry & Neurology | 2324 West Zion Road Unit 110, Salisbury, MD 21801 | 2020-03-30 |
| 1508404997 | Pridgett Harmon | Counselor | 2324 West Zion Road, Suite 112, Salisbury Md, MD 21801 | 2019-12-16 |
| 1821646324 | Diane Palmer | Counselor | 2324 West Zion Rd., Suit 112, Salisbury, MD 21801 | 2019-08-28 |
| 1558923672 | Oc Wellness LLC | Nurse Practitioner | 1410 S Salisbury Blvd Unit 1, Salisbury, MD 21801 | 2019-06-28 |
| 1033686670 | Megan Insley | Speech-Language Pathologist | 1213 Emeron Ave, Salisbury, MD 21801 | 2018-11-01 |
| 1811462831 | Kailyn Asbury | Registered Nurse | 100 E. Carroll St., Prmc Dept of Physical Medicine, Salisbury, MD 21801 | 2018-10-05 |
| 1750866380 | Marc Levin Mcdonald | Physical Therapist | 2420 North Salisbury Blvd Unit 5, Salisbury, MD 21801 | 2018-09-28 |
| 1891277695 | Lindsay Britt Stallings | Counselor | 116 West Main St. Suite 204, Salisbury, MD 21801 | 2018-08-29 |
| Find all providers in zip 21801 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104244698 | Medplus Pharmacy, LLC | Pharmacy | 1411 S Salisbury Blvd, Unit B, Salisbury, MD 21801-7126 | 2014-04-01 |
| 1023275203 | Meezaan Corporation | Pharmacy | 817 Snow Hill Rd, Ste 2, Salisbury, MD 21804-1900 | 2008-05-16 |
| 1033239330 | Walgreen Co | Pharmacy | 1505 E Innes St, Salisbury, NC 28146-6018 | 2007-03-30 |
| 1700937661 | North Carolina Cvs Pharmacy LLC | Pharmacy | 1702 E Innes St, Salisbury, NC 28146-6024 | 2007-01-16 |
| 1689735706 | Food Lion LLC | Pharmacy | 2210 Executive Dr., Salisbury, NC 28145 | 2006-12-12 |
| 1114932118 | Walgreen Co | Pharmacy | 1906 W Innes St, Salisbury, NC 28144-2433 | 2006-07-29 |
| 1215952866 | The Great Atlantic and Pacific Tea Company Inc | Pharmacy | 125 W College Ave, Salisbury, MD 21804-6961 | 2006-07-13 |
| 1528578895 | Daprile Rx, LLC | Pharmacy | 20 Main Street, Salisbury, CT 06068 | 2017-10-02 |
| 1194242891 | Walgreen Co | Pharmacy | 1605 E Innes St, Salisbury, NC 28146-6022 | 2017-08-24 |
| 1033576087 | Moose Pharmacy of Salisbury | Pharmacy | 1408 W Innes St, Salisbury, NC 28144-2502 | 2016-01-21 |
| Find all providers in SALISBURY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.