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General NPI Number Information
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NPI Number | 1790167740
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Entity Type | Organization
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Legal Business Name | TIDALHEALTH SURGERY CENTER, LLC
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Dates
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Enumeration Date | 06/26/2015
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 804 SNOW HILL RD
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City | SALISBURY
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State | MD
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Zip | 21804-1938
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Country | US
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Telephone | 410-543-7171
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Fax |
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Provider Business Mailing Address
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Address Line | 100 E CARROLL ST
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City | SALISBURY
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State | MD
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Zip | 21801-5422
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | BRUCE ISHMAEL RITCHIE
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Credential |
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Telephone | 410-543-7298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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