Organization
MODERN MEDICAL SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS WOIDERSKI (VICE PRESIDENT)
(231) 627-9949
Entity
Organization
Contact information
Practice address
127 N MAIN ST, CHEBOYGAN, MI 49721-1637
(231) 627-9949
(231) 627-8294
Mailing address
PO BOX 345, CHEBOYGAN, MI 49721-0345
(231) 627-9949
(231) 627-8294
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301005498
MI
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2041132
PK
—
05
—
2700723
—
MI
05
—
2700732
—
MI
Enumeration date
06/11/2006
Last updated
07/24/2025
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