Organization
FAMILY FARE, LLC
Active
Other names
FAMILY FARE PHARMACY 123
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
1185 WASHINGTON AVE, HOLLAND, MI 49423-7729
(616) 392-7504
(616) 392-8021
Mailing address
1527 MOMENTUM PL, SPARTAN PHARMACY NORTH, CHICAGO, IL 60689-5315
(616) 878-8584
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301006944
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2354277
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
4075494
—
MI
Enumeration date
09/25/2006
Last updated
12/07/2023
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