Peninsula Pharmacy

LBN: Peninsula Pharmacy Inc
Peninsula Pharmacy is an health care organization with primary practice located at 1414 W Fair Ave Suite 133, Marquette MI 49855-2675. The organization recently has 5 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Parenteral & Enteral Nutrition, Suppliers / Community/Retail Pharmacy, Suppliers / Home Infusion Therapy Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Peninsula Pharmacy Inc can be contacted via phone (906) 225-3902, or through Jenema, Tyler L via phone (906) 225-3902.

Contact Information

Primary practice address
1414 W Fair Ave Suite 133 Marquette MI 49855-2675
Phone: (906) 225-3902
Fax: (906) 226-2661
Website:
Map and Directions
Authorized official contact:
Name: Jenema, Tyler L R.PH.
Phone: (906) 225-3902

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 5301010345 Michigan
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 1199700001 Michigan
Suppliers / Parenteral & Enteral Nutrition 332BP3500X 1003807413 Michigan
Suppliers / Community/Retail Pharmacy 3336C0003X 5301010345 Michigan
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X 5301010345 Michigan

Profile Details

NPI number 1003807413
LBN Legal business name Peninsula Pharmacy Inc
DBA Doing business as Peninsula Pharmacy
Authorized official Jenema, Tyler L R.PH.
Entity Organization
Organization subpart 1 No
Enumeration date Nov 3rd, 2005
Last updated Nov 16th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003807413 NPPES
Michigan Other 1003807413 BCBS - MICHIGAN
Michigan Other 2357362 BCBS - MICHIGAN
Michigan MEDICAID 3409001 BCBS - MICHIGAN

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