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Organization

TDS INC

Active
Other names
CRYSTAL FALLS PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
JORDAN MAX MARCHETTI (OWNER/PRESIDENT)
(906) 774-3654
Entity
Organization

Contact information

Practice address
1363 US HIGHWAY 2, CRYSTAL FALLS, MI 49920-1089
(906) 875-3601
(906) 875-3604
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
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
5301008670
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100264975
WI
01
2042750
PK
05
2370132
MI
Enumeration date
07/16/2007
Last updated
07/23/2025
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