Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Peninsula Pharmacy Inc

Organization Pharmacist · NPI 1003807413

Peninsula Pharmacy Inc provides Pharmacist services in Marquette, Michigan. Licensed in Michigan. Registered with an NPI since 2005.

Licensed in
MI
In the registry since
2005
Specialties on file
5
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1414 W Fair Ave Ste 133
Marquette, MI 49855-2675
Phone: (906) 225-3902
Fax: (906) 226-2661
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 5301010345 (MI)
Pharmacist Taxonomy 183500000X · Licence 5301010345 (MI)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 1199700001 (MI)
Parenteral & Enteral Nutrition Supplies (DME) Taxonomy 332BP3500X · Licence 1003807413 (MI)
Home Infusion Therapy Pharmacy Taxonomy 3336H0001X · Licence 5301010345 (MI)

Record details

NPI number1003807413
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Praveen Challa — President · (906) 225-3902
Other names Peninsula Pharmacy; Peninsula Pharmacy
NPI enumeratedNovember 3, 2005
Last updated in NPPESDecember 18, 2024
Certification dateDecember 18, 2024
Mailing address1414 W Fair Ave, Suite 133, Marquette, MI 49855-2675

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