Organization
PREVO'S FAMILY MARKETS, INC
Active
Other names
D & W Pharmacy 1573, D AND W PHARMACY 1573
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS RPH (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
6425 28TH ST SE, GRAND RAPIDS, MI 49546-6917
(616) 949-0340
(616) 949-0903
Mailing address
1527 MOMENTUM PL, SPARTAN PHARMACY NORTH, CHICAGO, IL 60689-5315
(616) 878-8584
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008233
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2368997
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/06/2006
Last updated
04/21/2026
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