Organization
FAMILY FARE, LLC
Active
Other names
FAMILY FARE PHARMACY 1511
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS RPH (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
2470 W I75 BUSINESS LOOP, GRAYLING, MI 49738-2008
(989) 348-5335
(989) 348-7820
Mailing address
1527 MOMENTUM PL, CHICAGO, IL 60689-5315
(616) 878-8584
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301006961
MI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205936531
NPI
MI
01
—
2352526
NCPDP
MI
01
—
4084690
MI-DME
MI
Enumeration date
09/25/2006
Last updated
12/07/2023
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