TDS INC NPI 1811974488

NPI Details

TDS INC is a community/retail pharmacy pharmacy in Iron Mountain, MI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. TDS INC NPI is 1811974488. The provider is registered as an organization entity type.

The provider's business location address is:

1112 S STEPHENSON AVE
IRON MOUNTAIN, MI
ZIP 49801-038
Phone: (906) 774-3654
Fax: (906) 774-5502

The provider's authorized official is Jordan Max Marchetti .
The authorized official title is Owner/president and has the following contact phone number (906) 774-3654.

The CLIA number assigned to this NPI record is 23D2188654 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Fee covid-19 vac 13 res (HCPCS:0124A)
• Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
• Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
• Fee covid-19 vac 14 res (HCPCS:0134A)
• Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
• Influenza vaccine split virus, preservative free (HCPCS:90662)
• Adm sarscov2 30mcg/0.3ml bst (HCPCS:0004A)
• Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home (HCPCS:M0201)
• Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage (HCPCS:90686)
• Influenza vaccine, quadrivalent derived from recombinant dna (HCPCS:90682)
• Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free (HCPCS:90674)

The enumeration date for this NPI number is 12/27/2005 and was last updated on 7/23/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.