TIDALHEALTH PENINSULA REGIONAL, INC. (NPI# 1033592662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033592662 |
| Entity Type | Organization |
| Organization Name | TIDALHEALTH PENINSULA REGIONAL, INC. |
| Other Organization Name | PENINSULA REGIONAL MEDICAL CENTER BREAST CENTER |
| Practice Address |
804 Snow Hill Rd Salisbury MD 21804-1938 |
| Mailing Address |
100 E Carroll St Salisbury MD 21801-5422 |
| Practice Telephone | 4105437599 |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2020-10-26 |
| Authorized Official Name | BRUCE RITCHIE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4105437298 |
| Is Organization Subpart | Y |
| Parent Organization Name | PENINSULA REGIONAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0206X |
Clinic/Center Specialization: Radiology, Mammography |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Peninsula Regional Medical Center Breast Center | Other Name - Individual/Organization |
| TidalHealth Breast Center | 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 |
| 1851795017 | Tidalhealth Peninsula Regional, Inc. | Pharmacy | 11101 Cathage Rd, Berlin, MD 21811 | 2014-10-17 |
| 1285069617 | Tidalhealth Peninsula Regional, Inc. | Pharmacy | 100 E Carroll St, Salisbury, MD 21801-5422 | 2013-09-04 |
| 1780689463 | Tidalhealth Peninsula Regional, Inc. | Clinical Medical Laboratory | 100 E Carroll St, Salisbury, MD 21801-5422 | 2005-06-17 |
| Street Address |
804 SNOW HILL RD |
| City | SALISBURY |
| State | MD |
| Zip Code | 21804-1938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013973718 | David M. Schalk | Anesthesiology | 804 Snow Hill Rd, Salisbury, MD 21804-1938 | 2006-04-22 |
| 1790167740 | Peninsula Women's Center, LLC | Clinic/Center | 804 Snow Hill Rd, Salisbury, MD 21804-1938 | 2015-06-26 |
| 1386674091 | Chesapeake Surgery Center | Clinic/Center | 804 Snow Hill Rd, Salisbury, MD 21804 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578125969 | Lifes Energy Wellness Center Inc. | Community/Behavioral Health | 2324 West Zion Road Suite, Suite 112, Salisbury, MD 21804 | 2019-07-05 |
| 1578125340 | Lifes Energy Wellness Center Inc. | Counselor | 2324 West Zion Road Suite 112, Suite 112, Salisbury, MD 21804 | 2019-07-02 |
| 1093377855 | Lifes Energy Wellness Center Inc. | Clinic/Center | 2324 West Zion Road Suite #112, Salisbury, MD 21804 | 2019-07-02 |
| 1356904874 | Carly Showell Finkbeiner | Behavioral Analyst | 30507 Foxchase Dr, Salisbury, MD 21804 | 2019-04-19 |
| 1750844940 | Clifton Waters | Driver | 206 Davis St, Salisbury, MD 21804 | 2019-04-13 |
| 1487125415 | Rebecca J. Raygor | Social Worker | Wicomico High School, 201 Long Ave., Salisbury, MD 21804 | 2018-12-17 |
| 1639662745 | Peninsula Physical Therapy, LLC | Physical Therapist | 720 E College Ave Ste 11, Salisbury, MD 21804 | 2018-06-13 |
| 1376079533 | Kerry Choplin | Behavior Technician | 8032 Snow Hill Rd., Salisbury, MD 21804 | 2017-05-10 |
| 1558892992 | Three Lower Counties Community Services, Inc. | Clinic/Center | 1647 Woodbrooke Drive, Salisbury, MD 21804 | 2017-03-27 |
| 1508304759 | Driven Physiotherapy, LLC | Clinic/Center | 1029 Zircon Ct., Salisbury, MD 21804 | 2017-02-08 |
| Find all providers in zip 21804 | ||||
| Taxonomy Code | 261QR0206X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mammography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811084304 | Peninsula Surgical Group, P.a. | Clinic/Center | 145 East Carroll Street, Salisbury, MD 21801-5454 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043756232 | Atlantic General Hospital Corp | Clinic/Center | 12308 Ocean Gtwy Ste 5, Ocean City, MD 21842-9341 | 2017-01-11 |
| 1831283050 | Oakland Mri Center, LLC | Clinic/Center | 259 N. Fourth St., Oakland, MD 21550 | 2006-10-03 |
| 1336184241 | Washington Open Mri Inc | Clinic/Center | 15005 Shady Grove Rd Ste 110, Rockville, MD 20850-6341 | 2006-06-17 |
| 1639401839 | Kmh Healthcare Corporation | Clinic/Center | 4000 Old Court Rd, Suite 103, Pikesville, MD 21208-2800 | 2010-02-12 |
| 1285965335 | Kmh Healthcare Coporation | Clinic/Center | 724 Maiden Choice Ln, Suite 102, Catonsville, MD 21228-5911 | 2010-01-28 |
| 1861723926 | Khm Healthcare Corporation | Clinic/Center | 1147 S Hanover St, Baltimore, MD 21230-3717 | 2010-01-28 |
| 1861723900 | Kmh Healthcare Corporation | Clinic/Center | 2 Colgate Dr, Suite 204, Forest Hill, MD 21050-2624 | 2010-01-28 |
| 1831420975 | Kmh Healthcare Corporation | Clinic/Center | 10151 York Rd, Cockeysville, MD 21030-3314 | 2010-01-28 |
| 1780915835 | Kmh Healthcare Corporation | Clinic/Center | 1777 Reisterstown Rd, Suite14, Pikesville, MD 21208-1306 | 2010-01-28 |
| 1063446078 | Touchstone Imaging of Bowie LLC | Clinic/Center | 3327 Superior Ln, Ste 103, Bowie, MD 20715-1922 | 2006-07-10 |
| Find all providers with the same taxonomy | ||||
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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.