Provider Demographics
NPI:1669443255
Name:TDS PHARMACY INC
Entity Type:Organization
Organization Name:TDS PHARMACY INC
Other - Org Name:SHELDON MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:SHELDON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:810-989-1340
Mailing Address - Street 1:21 W SANILAC RD
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:MI
Mailing Address - Zip Code:48471-1036
Mailing Address - Country:US
Mailing Address - Phone:810-648-3535
Mailing Address - Fax:810-648-1896
Practice Address - Street 1:6895 GRATIOT RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48609-6813
Practice Address - Country:US
Practice Address - Phone:989-781-6358
Practice Address - Fax:989-781-6354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X, 332BP3500X, 332BX2000X, 335E00000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI52555OtherNORTHWOOD/NPN
MI0984111OtherHPM
MI2858916Medicaid
MI540G303950OtherBCBSM