Active NPI
TDS Inc
- Community/Retail Pharmacy
- Crystal Falls, MI
National Provider Identifier
1851590210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 5301008670
- Legal business name
- TDS INC
- Practice address
- 1363 US Highway 2
Crystal Falls, MI 49920-1089 - Phone
- (906) 875-3601
- Fax
- (906) 875-3604
- NPI assigned
- Jul 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jordan Max Marchetti
- Title
- Owner/President
- Phone
- (906) 774-3654
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 5301008670 | MI | Primary |
Addresses
Primary practice location
1363 US Highway 2
Crystal Falls, MI 49920-1089
Mailing address
PO Box 189
Iron Mountain, MI 49801-0189
Phone (906) 774-2841
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100264975 | Medicaid | WI | |
| 2042750 | Other | PK | |
| 2370132 | Medicaid | MI |
Other names 1
- CRYSTAL FALLS PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091109000522 | MI | Part B Supplier - Mass Immunization (Roster Biller Only) | 3375681588 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Crystal Falls, MI; Iron Mountain, MI; Norway, MI |
| O20140228000771 | MI | DME Supplier - Pharmacy | 3375681588 | Practice locations: Crystal Falls, MI |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| TDS, Inc. | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- TDS Inc
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Norway, MI
- NPI 1104613603
-
- Community/Retail Pharmacy
- Norway, MI
- NPI 1649382631
-
- Community/Retail Pharmacy
- Iron Mountain, MI
- NPI 1811974488
-
- Long Term Care Pharmacy
- Iron Mountain, MI
- NPI 1225506819
-
- Durable Medical Equipment & Medical Supplies
- Iron Mountain, MI
- NPI 1689756082
Locations
1340 US Highway 2
Crystal Falls, MI 49920
Phone (906) 875-3601
1363 US Highway 2
Crystal Falls, MI 49920
Phone (906) 875-3601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184544000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1753228800000",
"number": "1851590210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 189",
"city": "IRON MOUNTAIN",
"state": "MI",
"postal_code": "498010189",
"telephone_number": "906-774-2841",
"fax_number": "906-774-3015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1363 US HIGHWAY 2",
"city": "CRYSTAL FALLS",
"state": "MI",
"postal_code": "499201089",
"telephone_number": "906-875-3601",
"fax_number": "906-875-3604"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TDS INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-16",
"last_updated": "2025-07-23",
"certification_date": "2025-07-23",
"status": "A",
"authorized_official_last_name": "MARCHETTI",
"authorized_official_first_name": "JORDAN",
"authorized_official_middle_name": "MAX",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "906-774-3654"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MI",
"license": "5301008670",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100264975",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2042750",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2370132",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CRYSTAL FALLS PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Crystal Falls, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.