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General NPI Number Information
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NPI Number | 1811974488
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Entity Type | Organization
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Legal Business Name | TDS INC
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 1112 S STEPHENSON AVE
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-4038
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Country | US
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Telephone | 906-774-3654
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Fax | 906-774-5502
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Provider Business Mailing Address
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Address Line | PO BOX 189
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-0189
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Country | US
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Telephone | 906-774-2841
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Fax | 906-774-3015
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JORDAN MAX MARCHETTI
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Credential | PHARMD
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Telephone | 906-774-3654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 5301002759
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 1815-43
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH30515
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License Number State | FL
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