Healthcare Provider Details
I. General information
NPI: 1184695777
Provider Name (Legal Business Name): TDS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3090 MAIN ST
MARLETTE MI
48453-1279
US
IV. Provider business mailing address
21 W SANILAC RD
SANDUSKY MI
48471-1036
US
V. Phone/Fax
- Phone: 989-635-0266
- Fax: 989-635-3801
- Phone: 810-648-3535
- Fax: 810-648-1896
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | MI |
VIII. Authorized Official
Name: MR.
TIMOTHY
DALE
SHELDON
Title or Position: OWNER/PRESIDENT
Credential: RPH
Phone: 810-989-1340