Tidewater Nutrition Llc is a
Dietitian, Registered based in Centreville, Maryland. Tidewater Nutrition Llc is licensed to practice in * (Not Available) (license number ) and their current practice location is
120 Mckenney Ln, Centreville, Maryland. It can be reached at their office (for appointments etc.) via phone at
(410) 279-0621.
NPI number for Tidewater Nutrition Llc is 1710585245 and their current mailing address is 600-b Abruzzi Drive, Pmb #120, Chester, Maryland. Tidewater Nutrition Llc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1710585245.
Healthcare Provider's Profile
Full Name | Tidewater Nutrition Llc |
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Type | Facility |
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Speciality | Dietitian, Registered |
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Location | 120 Mckenney Ln, Centreville, Maryland |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1710585245
- Provider Enumeration Date: 10/16/2020
- Last Update Date: 10/16/2020
Medical Identifiers
Medical identifiers for Tidewater Nutrition Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710585245 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tidewater Nutrition Llc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tidewater Nutrition Llc 600-b Abruzzi Drive, Pmb #120, Chester, MD 21619 Ph: (410) 279-0621 | Tidewater Nutrition Llc 120 Mckenney Ln, Centreville, MD 21617-2139 Ph: (410) 279-0621 |
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