Organization
FAMILY FARE, LLC
Active
Other names
FAMILY FARE PHARMACY 1507
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
617 N WILLIAMS ST, MANCELONA, MI 49659-9766
(231) 587-8491
(231) 587-5259
Mailing address
1527 MOMENTUM PL, SPARTAN PHARMACY NORTH, CHICAGO, IL 60689-5315
(616) 878-8584
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301007322
MI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043310378
NPI
MI
01
—
2311924
NCPDP
MI
01
—
4822028
MI-DME
MI
Enumeration date
09/25/2006
Last updated
12/07/2023
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