Organization
TDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN MAX MARCHETTI PHARMD (OWNER/PRESIDENT)
(906) 774-3654
Entity
Organization
Contact information
Practice address
1112 S STEPHENSON AVE, IRON MOUNTAIN, MI 49801-4038
(906) 774-3654
(906) 774-5502
Mailing address
PO BOX 189, IRON MOUNTAIN, MI 49801-0189
(906) 774-2841
(906) 774-3015
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5301002759
MI
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH30515
FL
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
1815-43
WI
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100264973
—
WI
01
—
2040090
PK
—
05
—
2305781
—
MI
Enumeration date
12/27/2005
Last updated
07/23/2025
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