Organization · Type 2 NPI

Tidalhealth Peninsula Regional, Inc.

Clinic Pharmacy · Salisbury, MD

NPI number 1255153680 Active

Practice location

200 East Vine St
Salisbury, MD 21801

Fax (410) 543-4799

Specialties and licenses

Taxonomy	Code	License
Clinic Pharmacy Primary	3336C0002X	None listed

Clinic Pharmacy: A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

NPI record

NPI: 1255153680
Entity type: Organization (Type 2)
Issued: Oct 28, 2024
Last updated: Oct 28, 2024
Status: Active
Subpart: Yes of Tidalhealth Peninsula Regional, Inc.

Other names

Tidalhealth Home Scripts · doing business as

Authorized official

William Clifford Cooper, P.D.
Director of Ambulatory Pharmacy
(410) 543-7047

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1255153680

Tidalhealth Peninsula Regional, Inc.'s National Provider Identifier is 1255153680, issued on Oct 28, 2024. The primary taxonomy on file is Clinic Pharmacy (3336C0002X), and the practice location is in Salisbury, MD. The record was last updated on Oct 28, 2024.