Organization
FAMILY FARE, LLC
Active
Other names
VG's Pharmacy #1927
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS RPH (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
1390 N LEROY ST, FENTON, MI 48430-5310
(810) 629-6074
(810) 629-6125
Mailing address
SPARTAN PHARMACY NORTH, 1527 MOMENTUM PLACE, CHICAGO, IL 60689-5315
(616) 878-8584
(616) 878-8850
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009032
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118107
PK
—
Enumeration date
12/10/2008
Last updated
12/07/2023
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