Organization · Type 2 NPI

Tidalhealth Peninsula Regional, Inc.

Community/Retail Pharmacy · Berlin, MD

NPI number 1851795017 Active

Practice location

11101 Cathage Rd
Berlin, MD 21811

Fax (410) 543-4770

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	P06935 (MD)

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 …

8 other providers at this address

Other community/retail pharmacy providers in Berlin

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NPI record

NPI: 1851795017
Entity type: Organization (Type 2)
Issued: Oct 17, 2014
Last updated: Mar 2, 2026
Status: Active

Other names

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Tidalhealth Community Pharmacy · doing business as
Tidalhealth Home Scripts · other name

Authorized official

Kevin J Johnson
Director of Ambulatory Pharmacy SVC
(410) 543-7745

Verify this record

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 1851795017

Tidalhealth Peninsula Regional, Inc.'s National Provider Identifier is 1851795017, issued on Oct 17, 2014. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Berlin, MD. The record was last updated on Mar 2, 2026.