NPIMap

Tidalhealth Atlantic, Inc.

Organization Active NPI Pharmacy · Berlin, MD

NPI 1003227729 · NPPES record last updated Mar 11, 2026

Key facts

NPI
1003227729
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
License
P06310 (MD)
Legal business name
TIDALHEALTH ATLANTIC, INC.
Practice address
9733 Healthway Dr
Berlin, MD 21811-1155
Phone
(410) 641-9727
Fax
(410) 641-9750
NPI assigned
May 15, 2014
Organization subpart
No

Authorized official

Name
Stephanie Gary
Title
SVP, Finance/Cfo of Tidalhealth
Phone
(410) 912-6059

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Practitioners 95

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 95

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160812000402 MD Part B Supplier - Mass Immunization (Roster Biller Only) 2365437837 Practice locations: Berlin, MD
O20160818000130 MD Part B Supplier - Pharmacy 2365437837 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Berlin, MD

National Provider Directory

Tax ID family
Atlantic General Hospital Corp (35 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X P06310 MD Yes

Addresses

Primary practice location

9733 Healthway Dr
Berlin, MD 21811-1155

Mailing address

9733 Healthway Dr
Berlin, MD 21811-1155
Phone (410) 641-9240

Other names

  • TidalHealth Community Pharmacy Doing business as
  • Atlantic General Hospital Corporation Former legal business name
  • AGH RediScripts Pharmacy Other name

Other providers in Berlin, MD

All providers in Berlin, MD · Pharmacy in Maryland

Sources for this page

Verify at the official NPI Registry.