Organization
FAMILY FARE, LLC
Active
Other names
FAMILY FARE PHARMACY 254
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS RPH (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
1225 LEONARD ST NE, GRAND RAPIDS, MI 49505-5510
(616) 459-6203
(616) 454-8777
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
5301006943
MI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114027448
NPI
MI
01
—
2353340
NCPDP
MI
01
—
4075485
MI-DME
MI
Enumeration date
09/25/2006
Last updated
12/07/2023
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