Healthcare Provider Details

I. General information

NPI: 1649382631
Provider Name (Legal Business Name): TDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/19/2025
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 MAIN ST
NORWAY MI
49870-1238
US

IV. Provider business mailing address

PO BOX 189
IRON MOUNTAIN MI
49801-0189
US

V. Phone/Fax

Practice location:
  • Phone: 906-563-5151
  • Fax: 906-563-5978
Mailing address:
  • Phone: 906-774-2841
  • Fax: 906-774-3015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301005252
License Number StateMI

VIII. Authorized Official

Name: STEPHEN ROELL
Title or Position: OWNER
Credential: RPH
Phone: 906-774-1044