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General NPI Number Information
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NPI Number | 1093084303
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Entity Type | Organization
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Legal Business Name | JENSEN PROFESSIONAL VENTURES PC
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Dates
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Enumeration Date | 12/16/2011
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 968 E MICHIGAN AVE
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City | SALINE
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State | MI
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Zip | 48176-1586
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Country | US
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Telephone | 734-429-9053
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Fax | 734-944-3934
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Provider Business Mailing Address
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Address Line | 968 E MICHIGAN AVE
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City | SALINE
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State | MI
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Zip | 48176-1586
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Country | US
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Telephone | 734-429-9053
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Fax | 734-944-3934
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN ROBERT JENSEN
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Credential | PHARMD
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Telephone | 734-426-6210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301009721
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License Number State | MI
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