340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH210019A TIDALHEALTH PENINSULA REGIONAL INC (Active)
Print
Main Details
Name
TIDALHEALTH PENINSULA REGIONAL INC
Subdivision Name
MCCREADY HEALTH PAVILION - FMF EMERGENCY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210019A
Medicare Provider Number
210019
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/7/2021
Participating Start Date
3/15/2022
Participating Approval Date
1/26/2021
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
TidalHealth
John Jordan, Senior Director of Pharmacy
(410) 543-7054
Primary Contact
TidalHealth Peninsula Regional
Daehak Yim, 340B coordinator
(410) 543-7585
Addresses
Street Address
201 HALL HWY
CRISFIELD, MD 21817-1237
Billing Address
TIDALHEALTH PENINSULA REGIONAL INC
100 EAST CARROLL STREET
SALISBURY, MD 21801
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session