Healthcare Provider Details

I. General information

NPI: 1093084303
Provider Name (Legal Business Name): JENSEN PROFESSIONAL VENTURES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2011
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

968 E MICHIGAN AVE
SALINE MI
48176-1586
US

IV. Provider business mailing address

968 E MICHIGAN AVE
SALINE MI
48176-1586
US

V. Phone/Fax

Practice location:
  • Phone: 734-429-9053
  • Fax: 734-944-3934
Mailing address:
  • Phone: 734-429-9053
  • Fax: 734-944-3934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301009721
License Number StateMI

VIII. Authorized Official

Name: STEVEN ROBERT JENSEN
Title or Position: OWNER
Credential: PHARMD
Phone: 734-426-6210