Organization
PENINSULA ADVANCED CARE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER J JENEMA PHARM.D. (PHARMACIST)
(906) 869-0999
Entity
Organization
Contact information
Practice address
850 W BARAGA AVENUE, 1ST FLOOR, ROOM 1178, MARQUETTE, MI 49855
(906) 225-3902
Mailing address
1414 W FAIR AVE STE 133, MARQUETTE, MI 49855-5408
(906) 225-3902
(906) 226-2661
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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