Organization
FAMILY FARE, LLC
Active
Other names
VG's Pharmacy #1921
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS RPH (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
18005 SILVER PKWY, FENTON, MI 48430-3421
(810) 750-1572
(810) 629-9732
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
5301009037
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118102
PK
—
Enumeration date
12/09/2008
Last updated
12/07/2023
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