Peninsula Pharmacy Inc
Peninsula Pharmacy Inc is a healthcare organization registered as Home Infusion Agency in Marquette, MI, holding Type 2 (organization) NPI 1679618474 since 2007. The authorized official on file is Kent Jenema, Director of Pharmacy Operations.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1679618474 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Peninsula Pharmacy Inc |
| Other name | <Unavail> |
| Practice address | 1414 W FAIR AVE, SUITE 133, Marquette, MI, 49855 |
| Phone | 9062253902 |
| Fax | 9062262661 |
| Enumeration date | 2007-02-20 |
| Last updated in NPPES | 2022-11-16 |
Authorized official
| Name | Kent Jenema |
|---|---|
| Title | Director of Pharmacy Operations |
| Phone | 9062253902 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 251F00000X | Home Infusion Agency | Primary | 5301006679 | MI |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 470E21056 | Other | MI | BCBS-MI HIT |
Copy-ready billing details
Provider: Peninsula Pharmacy Inc NPI: 1679618474 Taxonomy: 251F00000X (Home Infusion Agency) Address: 1414 W FAIR AVE, SUITE 133, Marquette, MI, 49855
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1912823253 | Tiffany Dietsch | Individual | Ambulatory Care Registered Nurse | Marquette, MI |
| 1821090994 | John Bartlett | Individual | Internal Medicine Physician | Marquette, MI |
| 1811991250 | Martha Short | Individual | Internal Medicine Physician | Marquette, MI |
| 1447254883 | Leslie Robb | Individual | Internal Medicine Physician | Marquette, MI |
| 1174527519 | Islam Quasem | Individual | Internal Medicine Physician | Marquette, MI |
| 1083618425 | Melissa Broeders | Individual | Medical Physician Assistant | Marquette, MI |
| 1568467082 | James Gallagher | Individual | Primary Podiatric Medicine Podiatrist | Marquette, MI |
| 1184620908 | Kendall Tabor | Individual | Podiatrist | Marquette, MI |
Verify this record
Cross-check NPI 1679618474 against the authoritative CMS record: view Peninsula Pharmacy Inc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Peninsula Pharmacy Inc?
Who is the authorized official for Peninsula Pharmacy Inc?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2022-11-16.